Rhinocerebral mucormycosis treated with 32 gram liposomal amphotericin B and incomplete surgery: a case reportReportar como inadecuado




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BMC Infectious Diseases

, 1:22

First Online: 23 November 2001Received: 21 July 2001Accepted: 23 November 2001

Abstract

BackgroundMucormycosis 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 PresentationA 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; 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.

ConclusionsAlthough 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-1-22 contains supplementary material, which is available to authorized users.

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Autor: Atahan A Çagatay - Serkan S Öncü - Semra S Çalangu - Taner T Yildirmak - Halit H Özsüt - Haluk H Eraksoy

Fuente: https://link.springer.com/







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