Rhino-orbital and rhino-orbito-cerebral mucormycosis

Yoav P. Talmi*, Anna Goldschmied-Reouven, Mati Bakon, Iris Barshack, Michael Wolf, Zeev Horowitz, Miriam Berkowicz, Nathan Keller, Jona Kronenberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Rhino-orbito-cerebral mucormycosis (ROCM) is a devastating infection of immunocompromised hosts. We present our experience with 19 ROCM cases and attempt to define preferred diagnostic and treatment protocols. METHODS: All had tissue biopsies obtained studied by direct smear, histologic studies, and cultures. Imaging was obtained in 14 cases. RESULTS: Sixteen patients presented between August and November. Six had mixed fungal infections. Seven patients had end-stage underlying disease or infection and did not undergo surgery and 4 had an indolent form of disease. Patients were treated by surgery and by amphotericin B. The overall survival was 47%. CONCLUSIONS: ROCM may have seasonal incidence peaking in the fall and early winter. The therapeutic approach should be unchanged in cases of mixed fungal infections. Amphotericin B with aggressive debridement remains the mainstay of treatment. Early recognition and treatment are essential. A presentation and survival-dependent classification of ROCM are offered.

Original languageEnglish
Pages (from-to)22-31
Number of pages10
JournalOtolaryngology - Head and Neck Surgery
Volume127
Issue number1
DOIs
StatePublished - Jul 2002
Externally publishedYes

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