Biomaterial Database

Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B. 2011

B Saedi, and M Sadeghi, and P Seilani

Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran. saedi@tums.ac.ir

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. 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. CONCLUSIONS 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.

UI	MeSH Term	Description	Entries
D007275	Injections, Intravenous	Injections made into a vein for therapeutic or experimental purposes.	Intravenous Injections,Injection, Intravenous,Intravenous Injection
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009091	Mucormycosis	Infection in humans and animals caused by any fungus in the order MUCORALES (e.g., RHIZOPUS; MUCOR; CUNNINGHAMELLA; APOPHYSOMYCES; ABSIDIA; SAKSENAEA and RHIZOMUCOR) There are many clinical types associated with infection including central nervous system, lung, gastrointestinal tract, skin, orbit and paranasal sinuses. In humans, it usually occurs as an OPPORTUNISTIC INFECTION.	Mucorales Infection,Mucorales Infections,Mucormycoses,Infection, Mucorales,Mucormycose
D009336	Necrosis	The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D009668	Nose Diseases	Disorders of the nose, general or unspecified.	Nasal Diseases,Nasal Disorders,Disease, Nasal,Disease, Nose,Diseases, Nasal,Diseases, Nose,Disorder, Nasal,Disorders, Nasal,Nasal Disease,Nasal Disorder,Nose Disease
D009916	Orbital Diseases	Diseases of the bony orbit and contents except the eyeball.	Disease, Orbital,Diseases, Orbital,Orbital Disease
D010254	Paranasal Sinus Diseases	Diseases affecting or involving the PARANASAL SINUSES and generally manifesting as inflammation, abscesses, cysts, or tumors.	Disease, Paranasal Sinus,Diseases, Paranasal Sinus,Paranasal Sinus Disease,Sinus Disease, Paranasal,Sinus Diseases, Paranasal
D003646	Debridement	The removal of foreign material and devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed. (Dorland, 27th ed)	Debridements
D004198	Disease Susceptibility	A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases.	Diathesis,Susceptibility, Disease,Diatheses,Disease Susceptibilities,Susceptibilities, Disease