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| *Pancreatic [[panniculitis]] | | *Pancreatic [[panniculitis]] |
| *Gouty [[panniculitis]] | | *Gouty [[panniculitis]] |
| {| class="wikitable"
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| !Disease
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| !Differentiating Features
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| |Invasive aspergillosis
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| * The reverse halo sign on CT scan (characterized by central ground-glass opacity (GGO) which is surrounded by a partial or complete rim of consolidation)<ref name="pmid23683872">{{cite journal |vauthors=Okubo Y, Ishiwatari T, Izumi H, Sato F, Aki K, Sasai D, Ando T, Shinozaki M, Natori K, Tochigi N, Wakayama M, Hata Y, Nakayama H, Nemoto T, Shibuya K |title=Pathophysiological implication of reversed CT halo sign in invasive pulmonary mucormycosis: a rare case report |journal=Diagn Pathol |volume=8 |issue= |pages=82 |year=2013 |pmid=23683872 |pmc=3658989 |doi=10.1186/1746-1596-8-82 |url=}}</ref> is more common in patients with pulmonary mucormycosis than in those with invasive pulmonary aspergillosis<ref name="pmid25882362">{{cite journal |vauthors=Jung J, Kim MY, Lee HJ, Park YS, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH |title=Comparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis |journal=Clin. Microbiol. Infect. |volume=21 |issue=7 |pages=684.e11–8 |year=2015 |pmid=25882362 |doi=10.1016/j.cmi.2015.03.019 |url=}}</ref>
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| * Airway-invasive features, such as clusters of centrilobular nodules, peribronchial consolidations, and bronchial wall thickening, are more common in patients with invasive pulmonary aspergillosis<ref name="pmid258823622">{{cite journal |vauthors=Jung J, Kim MY, Lee HJ, Park YS, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH |title=Comparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis |journal=Clin. Microbiol. Infect. |volume=21 |issue=7 |pages=684.e11–8 |year=2015 |pmid=25882362 |doi=10.1016/j.cmi.2015.03.019 |url=}}</ref>
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| * Patients with orbital fungal infections are more likely to be infected with mucormycosis compared with Aspergillus<ref name="pmid26112869">{{cite journal |vauthors=Trief D, Gray ST, Jakobiec FA, Durand ML, Fay A, Freitag SK, Lee NG, Lefebvre DR, Holbrook E, Bleier B, Sadow P, Rashid A, Chhabra N, Yoon MK |title=Invasive fungal disease of the sinus and orbit: a comparison between mucormycosis and Aspergillus |journal=Br J Ophthalmol |volume=100 |issue=2 |pages=184–8 |year=2016 |pmid=26112869 |doi=10.1136/bjophthalmol-2015-306945 |url=}}</ref>
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| * Microscopic observation under ultraviolet light shows that the hyphae of aspergillus have characteristic dichotomous branching, parallel walls, and numerous septa. These septa structure is clearly different from those of the mucor.
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| * Unlike pulmonary aspergillosis, the prognosis of pulmonary mucormycosis has not improved significantly over the last ten years, mainly because of challenges in early diagnosis and the limited activity of current antifungal agents against Mucorales<ref name="pmid22167397">{{cite journal |vauthors=Hamilos G, Samonis G, Kontoyiannis DP |title=Pulmonary mucormycosis |journal=Semin Respir Crit Care Med |volume=32 |issue=6 |pages=693–702 |year=2011 |pmid=22167397 |doi=10.1055/s-0031-1295717 |url=}}</ref>
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| |Orbital cellulitis
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| * The ocular symptoms of rhino-cerebral mucormycosis (ROCM), such as facial edema, pain, and blepharoptosis, are similar to those of bacterial orbital cellulitis (BOC) soon after infection onset, therefore it maybe difficult to distinguish the two during the initial phase of infection
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| * Mucormycosis is generally more commonly observed in immunocompromised patients
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| * Limited eye movement was '''more common in patients with ROCM''' than in those with bacterial orbital cellulitis<ref name="pmid275010442">{{cite journal |vauthors=Son JH, Lim HB, Lee SH, Yang JW, Lee SB |title=Early Differential Diagnosis of Rhino-Orbito-Cerebral Mucormycosis and Bacterial Orbital Cellulitis: Based on Computed Tomography Findings |journal=PLoS ONE |volume=11 |issue=8 |pages=e0160897 |year=2016 |pmid=27501044 |pmc=4976984 |doi=10.1371/journal.pone.0160897 |url=}}</ref>
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| * Eyelid swelling was '''less common in patients with ROCM''' than in those with bacterial orbital cellulitis due to cavernous sinus involvement<ref name="pmid27501044">{{cite journal |vauthors=Son JH, Lim HB, Lee SH, Yang JW, Lee SB |title=Early Differential Diagnosis of Rhino-Orbito-Cerebral Mucormycosis and Bacterial Orbital Cellulitis: Based on Computed Tomography Findings |journal=PLoS ONE |volume=11 |issue=8 |pages=e0160897 |year=2016 |pmid=27501044 |pmc=4976984 |doi=10.1371/journal.pone.0160897 |url=}}</ref>
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| * Mucosal thickening on the paranasal sinuses is '''more common in ROCM''' than BOC<ref name="pmid275010443">{{cite journal |vauthors=Son JH, Lim HB, Lee SH, Yang JW, Lee SB |title=Early Differential Diagnosis of Rhino-Orbito-Cerebral Mucormycosis and Bacterial Orbital Cellulitis: Based on Computed Tomography Findings |journal=PLoS ONE |volume=11 |issue=8 |pages=e0160897 |year=2016 |pmid=27501044 |pmc=4976984 |doi=10.1371/journal.pone.0160897 |url=}}</ref>
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| |Extra nodal T cell lymphoma
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| * These tumors are more clearly classified as nasal-type extranodal T-cell/natural killer (T/NK) cell lymphoma and natural killer cell leukemia
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| * They are characterized immunophenotypically by the expression of CD2, CD3ϵ (but not CD3 and the T-cell receptor), and CD56<ref name="pmid27178138">{{cite journal |vauthors=Zhang Y, Wang T, Liu GL, Li J, Gao SQ, Wan L |title=Mucormycosis or extranodal natural killer/T cell lymphoma, similar symptoms but different diagnosis |journal=J Mycol Med |volume=26 |issue=3 |pages=277–82 |year=2016 |pmid=27178138 |doi=10.1016/j.mycmed.2016.04.005 |url=}}</ref>
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| * The lesion produced are destructive and involve the nasal cavity, oropharynx, upper palate, and larynx
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| * Immunophenotyping shows these lesions to be lymphoid in nature
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| |Cutaneous Anthrax
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| * Cutaneous anthrax is extremely rare in developed countries
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| * Usually patient history points towards the diagnosis of cutaneous anthrax
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| * Patient develops a painless ulcer with vesicles, edema, and has a history of exposure to animals or animal products<ref name="pmid9056659">{{cite journal |vauthors=Mallon E, McKee PH |title=Extraordinary case report: cutaneous anthrax |journal=Am J Dermatopathol |volume=19 |issue=1 |pages=79–82 |year=1997 |pmid=9056659 |doi= |url=}}</ref>; whereas patients with cutaneous mucormycosis are mainly debilitated (diabetics, hematological malignancies, organ transplant recepients) and present as a black necrotic eschar<ref name="pmid23930354">{{cite journal |vauthors=Skiada A, Petrikkos G |title=Cutaneous mucormycosis |journal=Skinmed |volume=11 |issue=3 |pages=155–9; quiz 159–60 |year=2013 |pmid=23930354 |doi= |url=}}</ref>
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Differential diagnosis
Mucormycosis must be differentiated from other conditions with similar presentation. Invasive fungal disease should be considered in any immunocompromised patient presenting with a new cranial neuropathy or ocular motility abnormality[1] for example:
Other differential diagnoses which may involve progressive facial swelling, ulceration and destruction and resemble mucormycosis include:
Histopathologically, mucormycosis may resemble:
- ↑ Trief D, Gray ST, Jakobiec FA, Durand ML, Fay A, Freitag SK, Lee NG, Lefebvre DR, Holbrook E, Bleier B, Sadow P, Rashid A, Chhabra N, Yoon MK (2016). "Invasive fungal disease of the sinus and orbit: a comparison between mucormycosis and Aspergillus". Br J Ophthalmol. 100 (2): 184–8. doi:10.1136/bjophthalmol-2015-306945. PMID 26112869.