Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-23T13:17:23.793Z Has data issue: false hasContentIssue false
  • English
  • Français

Successful treatment of rhinocerebral mucormycosis by a combination of aggressive surgical debridement and the use of systemic liposomal amphotericin B and local therapy with nebulized amphotericin – a case report

Published online by Cambridge University Press:  29 June 2007

P. Raj ,
E. J. Vella  and
R.C. Bickerton
P. Raj*
Affiliation:
Department of Otolaryngology, Warwick Hospital, Lakin Road, Warwick, UK.
E. J. Vella
Affiliation:
Department of Pathology, Warwick Hospital, Lakin Road, Warwick, UK.
R.C. Bickerton
Affiliation:
Department of Otolaryngology, Warwick Hospital, Lakin Road, Warwick, UK.
*
Address for correspondence:Mr P. Raj, 8 Warner Close, Warwick, CV34 5NE.
Get access Rights & Permissions [Opens in a new window]

Abstract

A case of mucormycosis involving the nose and paranasalsinuses in a 55-year-old man with recently diagnosed acute promyelocytic leukaemia is reported. It was successfully treated with a combination of aggressive surgical debridement and systemic amphotericin B. In addition, local nebulized amphotericin B was used as an adjunct totherapy. We believe this is only the second documented use of nebulized amphotericin in the management of sinonasal mucormycosis. The needfor a high index of suspicion and early aggressive management is emphasized.

Keywords

Mucormycosis, rhinocerebralAntifungal agentsParanasal sinuses, Surgery
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 4 , April 1998 , pp. 367 - 370
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beyer, J., Barzen, G., Risse, G. (1993) Aerosol amphotericin B for prevention of invasive pulmonaryaspergillosis. Antimicrobial Agents and Chemotherapy 37: 1367–1369.CrossRefGoogle Scholar
Chetchotisakd, P., Boonma, P., Sookpranee, M., Pairojkul, C. (1991) Rhinocerebral mucormycosis: a report of 11 cases. Southeast Asian Journal of Tropical Medicine and Public Health 22(2): 268–273.Google Scholar
Christenson, J. C., Shalit, I., Welch, D. F., Guruswamy, A., Marks, M. I. (1987) Synergistic action of amphotericin B and Rifampin against Rhizopus species. Antimicrobial Agents and Chemotherapy 31(11): 1775–1778.CrossRefGoogle ScholarPubMed
Conneally, E., Cafferky, M. T., Daly, P. A., Keane, C. T. (1990) Nebulized amphotericin B as a prophylaxis against invasive aspergillosis in granulocytopaenic patients. Bone Marrow Transplantation 5: 403–406.Google Scholar
Edwards, J. E. (1980) Clinical aspects of mucormycosis. In Mucormycosis. (Lehrer, R. I., moderator) (An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine). Annals of InternalMedicine 93(part 1): 93–108.Google Scholar
Eisenberg, R. S., Oatway, W. H. (1971) Nebulization of amphotericin B. American Review of Respiratory Diseases 103: 289.Google ScholarPubMed
Ericsson, M., Anniko, M., Gustaffson, H.,Hjalt, C.-A., Stenling, R., Tarnvik, A. (1993) A case of chronic progressive rhinocerebral mucormycosistreated with liposomal amphotericin B and surgery (letter). Clinical Infectious Diseases 16(4): 585–586.CrossRefGoogle Scholar
Fisher, E. W., Toma, A., Fisher, P. H., Cheesman, A. D. (1991) Rhinocerebral mucormycosis: use of liposomal amphotericin B. Journal of Laryngology and Otology 105(7): 575–577.CrossRefGoogle ScholarPubMed
Funada, H., Teshima, H., Fujita, S. (1978) Multiple pulmonary aspergillomas associated with chronicmyelogenous leukaemia in blast crisis. Japan Journal of Medicine 17: 316–320.Google Scholar
Gilbert, B. E., Wyde, P. R., Lopez-Berestein, G., Wilson, S. Z. (1994) Aerosolized amphotericin B liposomes for treatment of systemic Candida infections in mice. Antimicrobial Agents and Chemotherapy 38(2): 356–359.CrossRefGoogle ScholarPubMed
Gilbert, B. E., Wyde, P. R., Wilson, S. Z. (1992) Aersolized liposomal amphotericin B for treatmentof pulmonary and systemic Cryptococcus neoformans infections in mice. Antimicrobial Agents and Chemotherapy 36(7): 1466–1471.CrossRefGoogle Scholar
Gryn, J., Goldberg, J., Johnson, E. (1993) The toxicity of daily inhaled amphotericin B. American Journal of Clinical Oncology 16: 43–46.CrossRefGoogle ScholarPubMed
Ishida, M., Taya, N., Noiri, T., Kamihata, T., Hatta, C., Matsumoto, T., Sugiyama, Y., Yoshihara, W. (1993) Five cases of mucormycosis in paranasal sinuses. Acta Oto-Laryngologica (Suppl 501): 92–96.CrossRefGoogle ScholarPubMed
Kajs-Wyllie, M. (1995) Hyperbaric oxygen therapy for rhinocerebral fungal infection. Journal of Neuroscience Nursing 27(3): 174–181.CrossRefGoogle ScholarPubMed
Mills, W., Chopra, R., Linch, D. C., Goldstone, A. H. (1994) Liposomal amphotericin B in the treatment of fungal infections in neutropenic patients: a single centre experience of 133 episodes in 116 patients. British Journal of Haematology 86(4): 754–760.CrossRefGoogle ScholarPubMed
Myers, S. E., Devine, S. M., Topper, R. (1991) A phase 1 trial of prophylactic aerosolized amphotericin B in patients at risk for prolonged neutropenia. Clinical Research 39: 747A.Google Scholar
Ng, T. T., Denning, D. W. (1995) Liposomal amphotericin B (AmBisome) therapy in invasive fungal infections.Evaluation of United Kingdom compassionate use data. Archives of Internal Medicine 155(10): 1093–1098.CrossRefGoogle Scholar
Nussbaum, E. S., Hall, W. A. (1994) Rhinocerebral mucormycosis: changing patterns of disease. Surgical Neurology 41(2): 152–156.CrossRefGoogle ScholarPubMed
Oehling, A., Giron, M., Subira, M. L. (1975) Aerosol chemotherapy in bronchopulmonary candidiasis. Respiration 32: 179–184.CrossRefGoogle ScholarPubMed
Palacio, C., Acebedo, G., Lopez, A., Jodar, J. M. (1994) Remission of invasive sinusal and pulmonary aspergillosis with liposomal amphotericin B in a patient with chronic lymphatic leukaemia following failure with conventional amphotericin (Spanish). Sangre 39(5): 389–392.Google Scholar
Rangel-Guerra, R., Martinez, H. R., Saenz, C. (1985) Mucormycosis, report of 11 cases. Archives of Neurology 42: 578–581.CrossRefGoogle ScholarPubMed
Rodenhuis, S., Beaumont, F., Kauffman, H. F. (1984) Invasive pulmonary aspergillosis in a non-immunosuppressed patient: successful management with systemic amphotericin and flucytosine and inhaled amphotericin. Thorax 39: 78–79.CrossRefGoogle Scholar
Tkatch, L. S., Kusne, S., Eibling, D. (1993) Successful treatment of zygomycosis of the paranasal sinsuses with surgical debridement and amphotericin B colloidal dispersion. American Journal of Otolaryngology 14(4): 249–253.CrossRefGoogle Scholar
Winston, D. J. (1980) Therapy of mucormycosis, pp 101–4. In (Lehrer, R. I., moderator) Mucormycosis. (An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine). Annals of InternalMedicine 93(part 1):93–108.Google Scholar