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An In Vivo Murine Sciatic Nerve Model of Perineural Invasion
Published on: April 23, 2018
[Perineural spread by fungal cells. Case report and literature review]
Emilio Mayayo1, Julieta Landeyro, Alberto M Stchigel
1Servicio de Patología, Hospital Universitario Juan XXIII, Tarragona, España. emilio.mayayo@urv.cat
Abstract:
The perineural spread by fungal cells during the progression of the infection could be an important prognostic factor, especially in mycoses localized in the rhino-orbito-cerebral and pulmonary areas. We present a clinical case of a 73-year-old male, with diabetes and acute myelomonocytic leukaemia that began with tumefaction on the left side of his face, spreading to the sinus with invasion of the soft tissues and fistulae in the oral cavity. Clinical examination showed cerebral involvement. The histopathological sections and the histochemical techniques showed perineural involvement by fungal cells. Although the patient was diagnosed and treated in a short period of time, he died due to the infection. We would like to alert that perineural spread could be a retrograde way of mycoses dissemination, particularly in infections located in areas rich in neural cells.
Insights
Fungal perineural spread is a critical factor in mycoses, potentially aiding retrograde dissemination. This case highlights its role in fatal rhino-orbito-cerebral infections, emphasizing early detection for better outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Neuropathology
Background:
- Fungal infections can present with varied clinical manifestations.
- Perineural spread is a recognized pathway in some microbial infections.
- Risk factors for severe mycoses include immunosuppression and specific anatomical locations.
Observation:
- A 73-year-old male with diabetes and acute myelomonocytic leukemia presented with facial tumefaction.
- Infection spread to the sinuses, soft tissues, and oral cavity, with cerebral involvement noted.
- Histopathology confirmed perineural fungal cell invasion.
Findings:
- Perineural fungal spread was identified as a key feature in this case.
- The patient succumbed to the infection despite prompt diagnosis and treatment.
- This route of dissemination may be significant in infections of neural-rich areas.
Implications:
- Perineural spread of fungi may represent a retrograde dissemination pathway.
- Early recognition of perineural invasion is crucial for prognosis in certain mycoses.
- This highlights the importance of considering neural involvement in complex fungal infections.
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