RESUMO
Emphysematous cystitis (EC) and emphysematous myositis (EM) are rare disorders and concurrent occurrence of both in a patient with type 2 diabetes has not been reported previously. We report a patient who presented with pneumaturia and later with pain in thigh and diagnosed of both concurrently.
Assuntos
Comorbidade , Cistite/etiologia , Diabetes Mellitus Tipo 2/complicações , Enfisema/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Miosite/etiologia , Medição de Risco , Fatores de RiscoRESUMO
AIM: To describe the presentation and outcome of rhino-orbital-cerebral mucormycosis (ROCM) in adolescents with type 1 diabetes mellitus (T1DM). METHODS: The medical records of six patients of T1DM with ROCM admitted between October 2001 to January 2004 were analysed. RESULTS: The mean (+/- SD) age and duration of DM of these patients were 16.1+/-3.0 years and 26.3 +/- 24.9 months respectively. Four patients had ROCM at presentation, while two developed it during their hospital stay when recovering from diabetic ketoacidosis. Proptosis (100%) and ptosis (100%) were the most common symptoms, and ophthalmoplegia (85%) and vision loss (85%) were the most common signs. Maxillary sinus (85%) was the commonest paranasal sinus to be involved. All patients received amphotericin B and had appropriate surgery except one. Four patients survived. Patients who had altered sensorium, facial necrosis, palatal perforation and cerebral involvement at presentation had poor outcome. CONCLUSION: High index of suspicion of ROCM in T1DM and combined approach with amphotericin B and appropriate surgery is rewarding.