| Title | Rhinocerebral mucormycosis treated with 32 gram liposomal amphotericin B and incomplete surgery: a case report. | | Author(s) | Cagatay AA, Oncü SS, Calangu SS, Yildirmak TT, Ozsüt HH, Eraksoy HH | | Institution | Department of Clinical Bacteriology and Infectious Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. atayon@yahoo.com | | Source | BMC Infect Dis 2001.:22. | | MeSH | Adult
Amphotericin B
Antibiotics, Antifungal
Diabetes Complications
Drug Carriers
Humans
Liposomes
Male
Mucormycosis
Treatment Outcome
| | Abstract | BACKGROUND: Mucormycosis (or zygomycosis) is the term for infection caused by fungi of the order Mucorales. Mucoraceae may produce severe disease in susceptible individuals, notably patients with diabetes and leukemia. Rhinocerebral mucormycosis most commonly manifests itself in the setting of poorly controlled diabetes, especially with ketoacidosis.
CASE PRESENTATION: A 31-year-old diabetic man presented to the outpatient clinic with the following signs and symptoms: headache, periorbital pain, swelling and loss of vision in the right eye. On physical examination his right eye was red and swollen. There was periorbital cellulitis and the conjunctiva was edematous. KOH preparation of purulent discharge showed broad, ribbonlike, aseptate hyphae when examined under a fluorescence microscope. Cranial MRI showed involvement of the right orbit, thrombosis in cavernous sinus and infiltrates at ethmoid and maxillary sinuses. Mucormycosis was diagnosed based on these findings. Amphotericin B (AmBisome(R); 2 mg/kg.d) was initiated after the test doses. Right orbitectomy and right partial maxillectomy were performed; the lesions in ethmoid and maxillary sinuses were removed. The duration of the liposomal amphotericin B therapy was approximately 6 months and the total dose of liposomal amphotericin B used was 32 grams. Liposomal amphotericin B therapy was stopped six months later and oral fluconazole was started.
CONCLUSIONS: Although a total surgical debridement of the lesions could not be performed, it is remarkable that regression of the disease could be achieved with medical therapy alone. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 11737868 |
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