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Fungal Carbuncle Due to <i>Apophysomyces elegans</i>—A Case Report

Case Reports in Clinical Medicine 2019年第1期8卷 21-28页

作者： Dev Merlin Samuel narayanasami bharath Manoj Prabu Khalilur Rahman Arcot Rekha Saveetha Medical College and Hospital Saveetha Institute of Medical and Technological Sciences Chennai India

Background: Deep seated cutaneous fungal infection is a rare entity in surgical practice and is very often under diagnosed. Due to the atypical presentation and slow but aggressive progression of the disease, the associated mortality is high. Aim: The aim of this article to update clinicians about the peculiar presentation of mucormycosis caused by Apophysomyces elegans. Case Presentation: A 50 year old gentleman with a painful swelling and fever was admitted into our care. He had history of trivial trauma and no medical comorbid. His initial labs came back relatively unremarkable. He did not respond to an empirical antibacterial regimen and progressively worsened. The region was debrided and found to have granular secretions with sloughed tissue. On opening the dressing post operatively, a fungal mould was found. Fungal etiology was suspected and KOH mount confirmed the diagnosis. He was started on empirical IV antifungals, and local therapy while awaiting culture and sensitivity reports. However, he progressively deteriorated and succumbed to the disease eventually. Conclusion: Here we describe a deep seated cutaneous fungal infection in an immunocompetent patient and the challenges we faced during the course of his management. Fungal etiology is generally encountered in immunocompromised hosts. Deep seated cutaneous fungal infections with poor response to antifungal therapy and systemic sepsis led to this patients’ demise. This being the case, the onus is on the clinicians to diagnose a fungal etiology early and start appropriate anti fungal measures.

关键词： Mucormycosis Deep Seated Cutaneous Fungal Infections Apophysomyces elegans

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Schwannomas—Atypical Presentation and Challenges

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Case Reports in Clinical Medicine 2019年第4期8卷 93-98页

作者： R. Vijai J. Ruban Kumar R. Arihanth Manoj Prabu narayanasami bharath Khalilur Rahman Arcot Rekha Saveetha Medical College and Hospital Chennai India

Introduction: Neurogenic tumors include schwannomas and neurofibro-mas. They occur often in the head and neck. However, their occurrence on the vagus is uncommon. A high index of suspicion is needed to order imaging in pelvic lesions that present atypically. Discussion: Schwannomas are hypointense on T1 and heterogeneously hyperintense on T2 on MRI. The histopathological appearance with Antoni type A and type B is typical of Schwannoma. Conclusion: Schwannomas are slow growing benign tumors that are separable from the parent nerve. Recurrence is uncommon after resection.

关键词： Cervical Presaccral IHC

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