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

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.
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.
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.
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
  • 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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