Cureus最新文献

{"title":"Endovascular Embolization for Chronic Subdural Hematomas: A Literature Review of the Current Evidence.","authors":"Andrés Sebastián Estrella López, Naomi Pauleth Espin Jiménez, Patricio Alejandro Montalvo Ramos, Gabriela Alejandra Castillo López","doi":"10.7759/cureus.80898","DOIUrl":"10.7759/cureus.80898","url":null,"abstract":"<p><p>Chronic subdural hematoma (cSDH) primarily affects elderly patients along with those who have multiple health problems, while it develops when blood collects between the dura mater and the brain. The condition results in substantial disability while also causing surgical treatment failures in certain cases. The occurrence of cSDH becomes more frequent as people age beyond 65 years old, which establishes this condition as a major health issue. The standard surgical evacuation method for treating this condition shows limited success because patients experience frequent recurrences, which motivates researchers to study endovascular embolization as an alternative treatment option. The promising endovascular embolization technique uses middle meningeal artery (MMA) embolization to target the blood supply of the neo-membrane surrounding the hematoma, thus preventing rebleeding and reducing recurrence. The available data shows that embolization of the MMA leads to better recurrence prevention than conventional surgical procedures among patients who face restrictions for surgery because of multiple health issues. The review analyzes current research about MMA embolization safety together with its effectiveness and appropriate applications for cSDH treatment. The existing evidence about endovascular embolization as adjunctive therapy to surgical procedures such as burr hole drainage or craniotomy provides a significant impact over standalone treatment for complex and recurrent cSDH cases, reducing recurrence, rescue rates, and complications. However, endovascular embolization also shows better clinical outcomes in reducing these outcomes, but for less complex cSDH cases. There is unclear or inconclusive evidence for overall cSDH patients because current research lacks large multicenter randomized controlled studies together with stringent quality standards and contains various patient groups and minimal study durations. The procedure's effectiveness remains unclear because researchers have not determined the best patient selection criteria, the most suitable embolic agent, or the most economical approach.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80898"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Peptide Receptor Radionuclide Therapy for the Treatment of Pancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis of Comparative Studies.","authors":"Jun Zhao, Xiaxia Pei, Yumin Li","doi":"10.7759/cureus.80817","DOIUrl":"10.7759/cureus.80817","url":null,"abstract":"<p><p>Peptide receptor radionuclide therapy (PRRT) showed promising potential in the management of patients with pancreatic neuroendocrine tumors (pNETs). However, there is still a lack of evidence on its relative efficacy and safety compared with other treatment options. This review aims to synthesize the existing evidence on the efficacy and safety of PRRT for pNETs compared to different treatments. An electronic search was conducted from inception to May 2024. Comparative studies, including randomized controlled trials (RCTs), cohort studies, and case-control studies, that focused on the use of PRRT for treating pNETs were included. Efficacy outcomes included disease control rate (DCR), complete response (CR), partial response (PR), stable disease (SD), progression-free survival (PFS), and overall survival (OS). Safety outcomes were grade 3-4 hematological and renal toxicity and adverse events (AEs). Nine studies met the inclusive criteria. Among them, only one (11.1%) study was an RCT. Meta-analysis between full and reduced dosages of 177Lu-DOTATATE for G1-G2 pNETs revealed no significant differences in DCR, CR, PR, SD, and PFS between the groups. However, the full dosage group showed superior efficacy in some outcomes (DCR, CR, and PR). When PRRT was compared to other treatments such as surgery, chemotherapy, and targeted agents, it was associated with longer PFS and OS. Additionally, PRRT combined with capecitabine and salvage PRRT also showed efficacy in advanced cases. Safety analysis indicated that PRRT is well-tolerated, with minimal severe toxicity reported. PRRT is a promising therapeutic option for patients with advanced pNETs, offering a balance of efficacy and safety compared to other available treatments based on the low quality of evidence. Full-dosage PRRT may provide better outcomes than reduced dosages, and salvage PRRT remains effective for progressive disease. However, further high-quality RCTs are needed to confirm these findings and optimize PRRT usage in pNETs.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80817"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Anesthetist Leadership Styles and Their Resilience: A Single-Center Study.","authors":"Laurence Weinberg, Elizabeth P Hu, Mark M Youssef, Benjamin Churilov, Dong-Kyu Lee","doi":"10.7759/cureus.80848","DOIUrl":"10.7759/cureus.80848","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the association between the leadership styles and resilience of anesthetists in leadership roles.</p><p><strong>Methodology: </strong>This prospective study of all anesthetists in leadership roles within a university teaching hospital in Melbourne, Australia, employed three validated, anonymous questionnaires (Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Resilience Scale). Questionnaire data were summarized using descriptive statistics and presented as counts and proportions. Spearman's rank correlation was used to evaluate quantitative continuous variables to identify linear relationships.</p><p><strong>Results: </strong>Of the 14 anesthetists in leadership roles, 14 completed all three questionnaires (response rate 100%). Ten participants (71.5%) displayed behaviors consistent with transformational leadership. Three participants (21.4%) displayed behaviors typically associated with transactional leadership, and one (7.1%) exhibited characteristics consistent with passive-avoidant leadership. Anesthetists with transformational leadership styles exhibited significantly higher resilience scores than those with transactional or passive-avoidant leadership styles. Those with transformational leadership qualities also had increased job satisfaction overall.</p><p><strong>Conclusion: </strong>Anesthetists who exhibit transformational and authentic leadership are likely to be more resilient than those with transactional or passive-avoidant leadership styles. Higher levels of resilience were also associated with greater role effectiveness and experiencing greater levels of job satisfaction.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80848"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intertransverse Process Block With Catheter Placement for Postoperative Pain Management in a Patient With Alcoholic Liver Disease and Portal Hypertension: A Case Report.","authors":"Keisuke Nakazawa, Ayano Takenaka, Takahiro Suzuki","doi":"10.7759/cureus.80788","DOIUrl":"10.7759/cureus.80788","url":null,"abstract":"<p><p>Epidural analgesia is typically avoided in patients with portal hypertension due to multiple risk factors: engorgement of epidural venous plexuses, platelet dysfunction despite normal counts, and potential postoperative coagulopathy following liver surgery. These risks persist even when preoperative coagulation parameters appear normal. While peripheral nerve blocks are increasingly utilized for minimally invasive laparoscopic procedures, intertransverse process block (ITPB) with catheter placement offers a high-quality analgesic strategy that supports early ambulation and postoperative recovery with a significantly reduced risk profile in such patients. A 76-year-old male patient with alcoholic liver cirrhosis (Child-Pugh class A) and a history of esophageal variceal bleeding underwent laparoscopic partial hepatectomy of segment 3 for suspected hepatocellular carcinoma. Despite normal coagulation parameters (prothrombin time-international normalized ratio 1.1 and activated partial thromboplastin time 33 seconds), epidural analgesia was contraindicated due to portal hypertension with multiple vascular anomalies. Bilateral ultrasound-guided ITPB was performed at the Th8-9 level with catheter placement in the intertransverse tissue complex. Analgesia was maintained with intermittent boluses of 0.25% levobupivacaine (10 mL bilaterally, twice daily) for three postoperative days, supplemented with intravenous patient-controlled analgesia (IV-PCA) fentanyl (baseline infusion 10 μg/hour, bolus dose 10 μg, lockout time 10 minutes). The patient reported minimal pain scores (numerical rating scale 0-2 at rest, 2-3 with movement), achieved early mobilization, and did not require any PCA boluses throughout recovery. Cold testing confirmed adequate sensory blockade from Th8 to Th11 on each postoperative day until catheter removal. ITPB with catheter placement provided safe and effective analgesia in a patient with portal hypertension, enabling early mobilization and rehabilitation without risking complications associated with epidural techniques. This approach represents a viable alternative to epidural analgesia in high-risk patients with compromised liver function and vascular abnormalities.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80788"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Preoperative Neutrophil-Lymphocyte Ratio in Predicting Prognosis After Liver Transplantation for Chronic Liver Failure.","authors":"Surbhi Abrol, Manish Tandon, Arun M Raghu, Chandrakant Pandey","doi":"10.7759/cureus.80749","DOIUrl":"10.7759/cureus.80749","url":null,"abstract":"<p><strong>Introduction: </strong>The neutrophil-lymphocyte ratio (NLR) is an easily calculable biomarker known to have a predictive value in cardiac disease, malignancy, and renal failure. However, it has not been studied before in chronic liver disease patients undergoing liver transplantation. We aimed to evaluate the role of the pre-transplantation NLR in predicting the prognosis of patients with chronic liver failure undergoing liver transplantation.</p><p><strong>Method: </strong>Data was retrospectively collected from 46 patients with chronic liver disease who underwent liver transplantation. The patients were divided into two groups. Group A had 23 patients who survived after liver transplantation. Group B had 23 patients who did not survive. NLR was calculated by dividing the percentage of neutrophils by the percentage of lymphocytes in peripheral blood. The NLR cut-off value was based on a receiver operating characteristic curve analysis. Postoperative complications were also noted.</p><p><strong>Results: </strong>Preoperative NLR of 3.46 can predict post-transplantation mortality, with the area under the curve (AUC) of 0.86, having a sensitivity of 86.96% and a specificity of 73.91%. NLR emerged as an independent predictor of mortality (hazard ratio (HR) = 4.1, p = 0.028) after adjusting for the Model for End-Stage Liver Disease-Sodium (MELD-Na), creatinine, and neutrophil count. A rising NLR trend was significantly associated with the development of postoperative complications like neurological disease (p < 0.001), coagulopathy (p = 0.004), and acute kidney injury (p = 0.043).</p><p><strong>Conclusion: </strong>A high preoperative NLR is a predictor of poor outcomes in liver transplantation patients with chronic liver disease.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80749"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Wolf in Sheep's Clothing: Pseudohypobicarbonatemia in a Patient With Multiple Myeloma.","authors":"Ziad Alahmadi, Zain Haq, Ami Patel, Joshua D King","doi":"10.7759/cureus.80782","DOIUrl":"10.7759/cureus.80782","url":null,"abstract":"<p><p>There are multiple methods to measure serum bicarbonate level which is crucial for diagnosis and management of acid-base disturbances. The most common method is directly measuring the total serum carbon dioxide (CO₂) concentration in a basic metabolic panel. Another method is by indirect calculation of the bicarbonate concentration via the Henderson-Hasselbalch equation using the measured pH and partial pressure of CO₂ (pCO₂) in plasma. Multiple confounders can cause discrepancies in the measured bicarbonate in each method, such as increased concentration of serum lipids or proteins, that can alter measurement assays, leading to spuriously low serum bicarbonate values. In our case, we present a patient with falsely low reported bicarbonate levels in the setting of increased paraproteins due to multiple myeloma.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80782"},"PeriodicalIF":1.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Culture and Sputum Smear Conversion Timelines and Their Associated Factors in Smokers Versus Non-smokers With Drug-Resistant Tuberculosis.","authors":"Sajjad Ali, Nabi Rahman Rahman, Ashraf, Rumman, Akmal Naveed, Abdul Ghafoor, Murad Ali, Ubaid Ullah","doi":"10.7759/cureus.80704","DOIUrl":"10.7759/cureus.80704","url":null,"abstract":"<p><p>Background Drug-resistant tuberculosis (DR-TB) is a global health challenge, with smoking potentially affecting treatment outcomes. Smoking compromises immune function and may interfere with the pharmacokinetics of anti-TB drugs. Delayed sputum smear and culture conversion are key indicators of prolonged treatment and infectiousness. This study explores the impact of smoking on these conversion timelines in DR-TB patients. Objective To identify and assess the overall treatment outcomes and the factors associated with delayed culture and sputum smear conversion in smokers compared to non-smokers among patients with drug-resistant tuberculosis. Methods This prospective cohort study was conducted at the Programmatic Management of Drug-Resistant TB (PMDT) unit at Mardan Medical Complex in Khyber-Pakhtunkhwa, Pakistan, from June 2020 to December 2024. All patients diagnosed with drug-resistant tuberculosis (DR-TB) were categorized into two groups based on their smoking status: smokers and non-smokers. Patient demographic and clinical information was collected through structured interviews and standardized questionnaires. The time to sputum smear and culture conversion (SCC) was longitudinally measured from the start of treatment until the patient achieved two consecutive negative smears and three consecutive negative cultures, respectively. Cox proportional hazards analysis was employed to evaluate the relationship between smoking status and time to SCC, adjusting for potential confounding factors. Kaplan-Meier survival curves were used to compare the time to SCC between the two groups, with statistical significance set at p < 0.05. Analyses were performed using SPSS software (version 29.0). Results Out of 281 DR-TB patients, 138 were smokers (49.12%) and 143 were non-smokers (50.88%). Non-smokers achieved faster sputum and culture conversion, with survival proportions dropping to 0.000 by 90 and 70 days, respectively. In contrast, smokers showed slower declines, with sputum conversion at 0.137 and culture conversion at 0.035 by 120 days. The mean sputum conversion time was 59 days for non-smokers and 104 days for smokers, while culture conversion took 43 days for non-smokers and 98 days for smokers. Multivariate analysis identified significant determinants for both groups: older age (≥36 years), lower BMI (<16 kg/m²), and higher sputum smear grades. Non-smokers were adversely affected by gastrointestinal upset and nephrotoxicity, while smokers were more negatively impacted by higher cigarette consumption, diabetes, and lung lesions. Long-term treatment regimens and resistance to antibiotics like levofloxacin and moxifloxacin reduced conversion rates in both groups. Conclusion Smoking not only impairs immune function but also influences the pharmacokinetics of anti-TB drugs, potentially leading to more prolonged and complicated treatment courses.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80704"},"PeriodicalIF":1.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11918488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Literature Review on Whether Immobilization of the Shoulder in External Rotation Improves Healing and Prevents the Recurrence of Acute Shoulder Dislocations.","authors":"Yasmin H Kazim","doi":"10.7759/cureus.80713","DOIUrl":"10.7759/cureus.80713","url":null,"abstract":"<p><p>Shoulder dislocations are one of the most frequent joint dislocations, with recurrent dislocations being a common complication. Common practice is to immobilize the shoulder in internal rotation for two to three weeks following closed reduction. However, recent literature suggests immobilization in external rotation can be an alternative management strategy. External rotation braces have been manufactured over the years to support and maintain this position. This literature review aims to gather current evidence on the conservative management of primary traumatic anterior shoulder dislocations and compare the immobilization of the shoulder joint in internal and external rotation. A literature search and review was performed using PubMed and Google Scholar. Key phrases and words that were used in the search engines included \"shoulder immobilization\" AND \"external rotation\", \"anterior shoulder dislocation immobilization\" AND \"external rotation\", \"reduced recurrence rate of shoulder dislocation\" AND \"external rotation\", \"external rotation immobilization\" AND \"Bankart lesion\" and \"internal versus external rotation\" AND \"shoulder dislocation\". The reviewed articles included were dated from 2014 to 2024 but additional valuable studies dating earlier than 2014 were also included to provide a foundation of understanding to this review. Included were nine clinical studies and randomized controlled trials, three cadaveric studies, eight studies focusing on magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) or arthroscopy, and seven systematic reviews and meta-analyses. Research revealed improved coaptation of the labrum on the glenoid rim in external rotation not only in cadavers but also in patients with the aid of various imaging techniques. However, these findings were not consistently observed when translated into clinical trials. Based on the available data presented in this literature review, there remains a deficiency in evidence to exclusively support the use of external rotation immobilization over conventional internal rotation immobilization after primary traumatic anterior shoulder dislocations. External rotation immobilization may benefit a specific population, particularly those that fall in the 20-40-year-old age group, with a specific injury pattern, such as Bankart lesions and greater tuberosity fractures; therefore, further studies are required to determine who will benefit the most from such interventions.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80713"},"PeriodicalIF":1.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent Dangers: The Growing Vulnerability of Older Adults in Fatal Road Traffic Accidents.","authors":"Stefania Ungureanu, Camelia-Oana Muresan, Veronica Ciocan, Raluca Dumache, Emanuela Stan, Georgiana-Denisa Gavrilita, Alexandra Enache","doi":"10.7759/cureus.80712","DOIUrl":"10.7759/cureus.80712","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults represent a growing and vulnerable road user group. Our aim was to develop targeted interventions and preventive measures for decreasing road deaths in older adults by establishing the circumstances and the characteristics leading to such fatalities with regard to each type of road user.</p><p><strong>Materials and methods: </strong>Medico-legal autopsy records of victims of road traffic accidents from Timișoara Institute of Legal Medicine (TILM), Romania, in a five-year period (2017-2021) were analyzed. Data was retrieved and grouped according to the victims' demographics (age and gender), date of the accident, type of road user (driver, passenger, pedestrian, cyclist), and traumatic injuries. Moreover, data from the traffic police reports regarding additional circumstances of the crash were retrieved.</p><p><strong>Results: </strong>A total of 51 medico-legal autopsies involving older adults (aged above 70 years) were performed at TILM in 2017-2021. Regarding the type of road user, pedestrians were the most affected group among older adults (n=17), followed by cyclists (n=13), passengers (n=11), and drivers (n=10). Most cases (n=9) occurred when the victims were hit by a car behind them. The second most seen circumstance that led to fatally injured older victims was represented by being hit by a moving vehicle while crossing the street outside of a marked crosswalk (n=7).</p><p><strong>Conclusion: </strong>Our findings illustrate the need to focus on road fatalities among older adults, as these tragic events affect this vulnerable group. Unfortunately, less attention has been given to the severity and significance of these incidents. Preventive campaigns focusing on road user education, safe driving, safe walking and the implementation of facile public transport or improved pedestrian crossings should be the key points.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80712"},"PeriodicalIF":1.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-abdominal Mucormycosis in an Immunocompetent Host: A Rare Presentation and Literature Review.","authors":"Sevag Hamamah, Nupur Savalia, Faizi Hai","doi":"10.7759/cureus.80730","DOIUrl":"10.7759/cureus.80730","url":null,"abstract":"<p><p>Mucormycosis is a severe, opportunistic infection caused by <i>Mucorales,</i> a taxonomical group of thermotolerant fungi primarily affecting the immunocompromised. Intra-abdominal involvement in mucormycosis is a rare entity, particularly in immunocompetent individuals. We present a fatal case of gallbladder and renal mucormycosis in an immunocompetent female, leading to septic shock and death. The diagnosis was confirmed via histopathology following cholecystectomy for suspected gangrenous cholecystitis and open right nephrectomy due to kidney infarction. Quantitative polymerase chain reaction of the tissue identified the presence of <i>Apophysomyces ossiformis.</i> The clinical picture was confounded by ongoing sepsis due to a <i>Klebsiella pneumoniae</i>-infected retroperitoneal hematoma<i>,</i> non-specific imaging findings, and the absence of traditional risk factors for mucormycosis, leading to a delayed diagnosis. Despite surgical debridement, initiation of liposomal amphotericin B with posaconazole, and aggressive treatment in the intensive care unit, the patient succumbed to complications of mucormycosis. Despite adequate antibiotic coverage, this case underscores the importance of considering Mucorales infection in otherwise immunocompetent patients with a deteriorating clinical condition. Early diagnosis and appropriate intervention are essential in enhancing mucormycosis survivability, though mortality rates remain high in severe cases.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e80730"},"PeriodicalIF":1.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}