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

Abstract

OBJECTIVE:

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.

• Authors: B Saedi, M Sadeghi, P Seilani
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 125 Issue 8 Pg. 807-10 (Aug 2011) ISSN: 1748-5460 [Electronic] England
• PMID: 21729440 (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