| چکیده انگلیسی مقاله |
Cerebral mucormycosis (CM) is a life-threatening manifestation of mucormycosis, an angioinvasive fungal infection caused by Mucorales. We sought to systematically review all available case reports to describe epidemiologic features, clinical manifestations, predisposing factors, and diagnostic and treatment strategies of CM. A systematic search was conducted using a combination of the following keywords: "Mucor", "Zygomycetes", "mucormycosis", "cereb*", "brain", "central nervous system", and "intracranial", separately and in combination until December 31st 2018. Data sources included PubMed, Scopus, EMBASE, Web of Science, Science Direct, and Proquest without limiting the time of publication. We included 287 articles corresponding to 345 cases of CM. Out of the 345 cases, 206 (60%) were male with a median age of 44 years; 130 (38%) were reported from North America; 87 (25%) from Asia; and 84 (24%) from Europe. The median time from onset of symptoms to presentation was 3-7 days (65/345, 65%). The highest mortality was observed among patients with diabetes mellitus (P=0.003). Debridement of infected brain tissue was associated with improved survival in CM cases (OR 1.5; 95% CI 01.3-1.8; P<0.0001). The use of liposomal amphotericin B (L-AMB) was significantly associated with patients' recovery (OR 2.09; 95% CI 1.2-3.4; P=0.003). The combination of L-AMB and posaconazole (12.5%) was more effective than the monotherapy treatment of CM cases (P=0.009). Clinicians should consider DM as an important risk factor for CM. Moreover, surgical debridement and antifungal combination therapy could be an effective approach in the management of CM patients. |
| نویسندگان مقاله |
Mohammadreza Salehi |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Shahram Mahmoudi |
Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Omid Rezahosseini |
Viro-immunology Research Unit, Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Sayed Jamal Hashemi |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Kazem Ahmadikia |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Farzad Aala |
Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Nasim Khajavirad |
Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Neda Alijani |
Department of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Alireza Izadi |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Muhammad Ibrahim Getso |
Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, Kano, Nigeria
Alireza Abdollahi |
Department of Pathology, School of Medicine, Imam Khomeini Hospital
Tehran University of Medical Sciences, Tehran, Iran
Arezoo Salami |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Seyedeh Rana Khatami |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Alireza Adibimehr |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Mojtaba Hedayat Yaghoobi |
Department of Infectious Diseases, Alborz University of Medical Sciences, Karaj, Iran
Mohammadmahdi Sabahi |
Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
Behshad Pazooki |
Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Farhad Yazdi |
Department of Infectious Diseases, Arak Social Security Organization Hospital, Arak, Iran
Jayran Zebardast |
Neurocognitive Science special Linguistics, Institute for Cognitive Science Studies, Tehran, Iran
Arash Seifi |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Malihe Hasan Nezhad |
Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Masoud Mardani |
Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sadegh Khodavaisy |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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