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Endoscopic management of rhinocerebral mucormycosis with topical and intravenous amphotericin B

  • B Saedi (a1), M Sadeghi (a1) and P Seilani (a2)

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.

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Copyright

Corresponding author

Address for correspondence: Dr B Saedi, Otolaryngology Research Center, Imam Khomeini Medical Center, Tehran University of medical sciences, Bagherkhan Street, Chamran Highway, Tehran 141973141, Iran Fax: 982166581628 E-mail: saedi@tums.ac.ir

References

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