Rhinocerebral Mucormycosis: Evolution of the Disease and Treatment Options

Rhinocerebral mucormycosis is recognized as a potentially aggressive and commonly fatal fungal infection. The classic presentation is involvement of nasal mucosa with invasion of the paranasal sinuses and orbit. Mucormycosis is most commonly seen in association with diabetic ketoacidosis, but diseas...

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Bibliographic Details
Published in:The Laryngoscope 1997-07, Vol.107 (7), p.855-862
Main Authors: Peterson, K. Linnea, Wang, Marilene, Canalis, Rinaldo F., Abemayor, Elliot
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
AIDS-Related Opportunistic Infections - diagnosis
AIDS/HIV
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Biological and medical sciences
Brain Diseases - diagnosis
Brain Diseases - microbiology
Brain Diseases - surgery
Child
Combined Modality Therapy
Debridement
Diabetic Ketoacidosis - complications
Ent and stomatologic mycoses
Female
Follow-Up Studies
Human mycoses
Humans
Immunocompromised Host
Immunosuppressive Agents - therapeutic use
Infectious diseases
Male
Medical sciences
Middle Aged
Mucormycosis - diagnosis
Mucormycosis - surgery
Mycoses
Nasal Mucosa - microbiology
Nose Diseases - diagnosis
Nose Diseases - microbiology
Nose Diseases - surgery
Opportunistic Infections - diagnosis
Orbital Diseases - diagnosis
Orbital Diseases - microbiology
Orbital Diseases - surgery
Paranasal Sinus Diseases - diagnosis
Paranasal Sinus Diseases - microbiology
Paranasal Sinus Diseases - surgery
Retrospective Studies
Survival Rate
Treatment Outcome
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Summary:Rhinocerebral mucormycosis is recognized as a potentially aggressive and commonly fatal fungal infection. The classic presentation is involvement of nasal mucosa with invasion of the paranasal sinuses and orbit. Mucormycosis is most commonly seen in association with diabetic ketoacidosis, but disease demographics have changed with the onset of AIDS and the advent of powerful immunosuppressive drugs. Treatment includes aggressive debridement, systemic antifungal therapy, and control of underlying comorbid factors. Although surgical intervention remains essential, advances in medical therapy have permitted a more limited surgical approach to minimize functional loss without compromising survival. We present the UCLA experience with rhinocerebral mucormycosis from 1955 to 1995, with emphasis on the evolution of disease presentation and alternative treatment options.
ISSN:0023-852X
1531-4995
DOI:10.1097/00005537-199707000-00004