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Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B.

AbstractOBJECTIVE:
Mucormycosis is an aggressive fungal infection which may still cause fatal complications. However, the rarity of this disease has made optimal treatment a controversial issue. This study aimed to evaluate the use of topical amphotericin B in endoscopic management of rhinocerebral mucormycosis.
SUBJECTS AND METHODS:
Thirty patients with infection limited to the nose and sinuses were selected. Patients underwent endoscopic debridement of all necrotic tissue; cottonoid pledgets soaked in amphotericin B solution were then placed in the nasal cavity. Subsequently, long-term antifungal therapy was administered.
RESULTS:
The overall survival rate was 60 per cent (18 cases); survival rates in the diabetic and malignancy groups were 70.58 and 40 per cent, respectively. Apart from predisposing factors, orbital and maxillary sinus involvement also had a significant correlation with patient outcome.
CONCLUSION:
Topical use of amphotericin B combined with endoscopic surgical debridement, followed by intravenous amphotericin B treatment, may constitute acceptable management for selected patients, with less morbidity than conventional treatments.
AuthorsB Saedi, M Sadeghi, P Seilani
JournalThe Journal of laryngology and otology (J Laryngol Otol) Vol. 125 Issue 8 Pg. 807-10 (Aug 2011) ISSN: 1748-5460 [Electronic] England
PMID21729440 (Publication Type: Journal Article)
Chemical References
  • Antifungal Agents
  • Amphotericin B
Topics
  • Administration, Topical
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amphotericin B (administration & dosage, therapeutic use)
  • Antifungal Agents (administration & dosage, therapeutic use)
  • Debridement
  • Diabetes Complications (microbiology)
  • Disease Susceptibility
  • Drug Delivery Systems (methods)
  • Endoscopy
  • Female
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Mucormycosis (drug therapy, pathology, surgery)
  • Necrosis
  • Nose Diseases (drug therapy, microbiology, surgery)
  • Orbital Diseases (microbiology)
  • Paranasal Sinus Diseases (drug therapy, microbiology, surgery)
  • Survival Rate
  • Treatment Outcome
  • Young Adult

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