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Case Reports
. 2019 Jan-Jun;9(1):192-196.
doi: 10.4103/ams.ams_231_18.

Rhinocerebral Mucormycosis: A Prospective Analysis of an Effective Treatment Protocol

Ashok Ramadorai  1 , Poornima Ravi  2 , Vinod Narayanan  1
Affiliations
Case Reports

Rhinocerebral Mucormycosis: A Prospective Analysis of an Effective Treatment Protocol

Ashok Ramadorai et al. Ann Maxillofac Surg. 2019 Jan-Jun.

Abstract

Objective: The objective of this study was to prospectively analyze the effectiveness of a treatment protocol in patients diagnosed with rhinocerebral mucormycosis.

Materials and methods: This series included ten patients who reported with suspicious clinical signs of mucormycosis. The diagnosis was established by histopathology, and computed tomography imaging was used to assess the extent of spread. All patients were treated with immediate radical surgical debridement and antifungal chemotherapy with amphotericin B. Simultaneous correction of the underlying immunosuppressive condition was carried out. The primary outcome assessed was disease-free survival, and the patients were followed up for up to 6 months after discharge.

Results: In this series, the cause of immunosuppression was uncontrolled diabetes mellitus in all patients. All the patients responded to the treatment protocol and were free of the disease up to 6 months of follow-up.

Conclusion: Mucormycosis is an invasive and potentially fatal disease. Prognosis can be improved by early recognition and prompt treatment with aggressive resection, intravenous amphotericin B, and control of the patient's underlying systemic condition.

Keywords: Amphotericin B; diabetic ketoacidosis; mucormycosis; opportunistic fungi.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Extent of resection performed, with specimens
Figure 2
Figure 2
(a) Mucormycosis presenting with facial nerve palsy. (b) Mucormycosis presenting with facial swelling
Figure 3
Figure 3
Extent of palatal ulceration
Figure 4
Figure 4
Computed tomography presentation of mucormycosis. (a) Erosion of maxillary sinus. (b) Extension into frontal sinus. (c) Retrobulbar soft-tissue involvement
Figure 5
Figure 5
Histopathological picture
See this image and copyright information in PMC

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