Imaging Findings of Rhinocerebral Mucormycosis

Herrera, Diego A.; Dublin, Arthur B.; Ormsby, Eleanor L.; Aminpour, Shervin; Howell, Lydia Pleotis

doi:10.1055/s-0028-1096209

Cited by 119 publications

(59 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In case of bone destruction diagnosed on CT, magnetic resonance imaging should be used to reveal the full extent of disease . In an institutional series of patients with mucormycosis ( n = 27) approximately half of the patients with sinus involvement showed intracranial spread of disease .…”

Section: Resultsmentioning

confidence: 99%

ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of mucormycosis 2013

Cornely¹,

Arıkan-Akdağlı²,

Dannaoui³

et al. 2014

Clinical Microbiology and Infection

597

567

View full text Add to dashboard Cite

These European Society for Clinical Microbiology and Infectious Diseases and European Confederation of Medical Mycology Joint Clinical Guidelines focus on the diagnosis and management of mucormycosis. Only a few of the numerous recommendations can be summarized here. To diagnose mucormycosis, direct microscopy preferably using optical brighteners, histopathology and culture are strongly recommended. Pathogen identification to species level by molecular methods and susceptibility testing are strongly recommended to establish epidemiological knowledge. The recommendation for guiding treatment based on MICs is supported only marginally. Imaging is strongly recommended to determine the extent of disease. To differentiate mucormycosis from aspergillosis in haematological malignancy and stem cell transplantation recipients, identification of the reverse halo sign on computed tomography is advised with moderate strength. For adults and children we strongly recommend surgical debridement in addition to immediate first-line antifungal treatment with liposomal or lipid-complex amphotericin B with a minimum dose of 5 mg/kg/day. Amphotericin B deoxycholate is better avoided because of severe adverse effects. For salvage treatment we strongly recommend posaconazole 4×200 mg/day. Reversal of predisposing conditions is strongly recommended, i.e. using granulocyte colony-stimulating factor in haematological patients with ongoing neutropenia, controlling hyperglycaemia and ketoacidosis in diabetic patients, and limiting glucocorticosteroids to the minimum dose required. We recommend against using deferasirox in haematological patients outside clinical trials, and marginally support a recommendation for deferasirox in diabetic patients. Hyperbaric oxygen is supported with marginal strength only. Finally, we strongly recommend continuing treatment until complete response demonstrated on imaging and permanent reversal of predisposing factors.

show abstract

Section: Resultsmentioning

confidence: 99%

ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of mucormycosis 2013

Cornely¹,

Arıkan-Akdağlı²,

Dannaoui³

et al. 2014

Clinical Microbiology and Infection

597

567

View full text Add to dashboard Cite

show abstract

“…A pattern of nasal cavity, orbital, ethmoid, and maxillary involvement is highly suggestive [14]. For the head and neck surgeon, MRI can better delineate areas of involvement, which may guide surgical intervention in the form of endoscopic versus open surgical debridement and simple debridement versus more extensive resections [15].…”

Section: Discussionmentioning

confidence: 99%

Imaging of Acute Invasive Fungal Rhinosinusitis in a Patient with Gorlin Syndrome and Acute Lymphocytic Leukemia

Donovan

Thompson

Sandlund

et al. 2013

Case Reports in Otolaryngology

View full text Add to dashboard Cite

Gorlin Syndrome (GS), also known as nevoid basal cell carcinoma syndrome, is a rare autosomal dominant condition characterized by developmental abnormalities and predisposition to certain neoplasms. Acute invasive fungal rhinosinusitis (AIFRS) is an uncommon clinical entity characterized by high morbidity and mortality. In immunocompromised patients, computed tomography plays a critical role in screening for suspected AIFRS. However, due to the association between exposure to ionizing radiation and subsequent development of malignancies in patients with GS, patients with GS and suspected AIFRS present a unique and challenging clinical scenario. We present a case of a pediatric patient with GS and acute lymphocytic leukemia (ALL) diagnosed with AIFRS; to the best of our knowledge, it is the only case described in the literature.

show abstract

“…Isointense and hypointense lesions are observed within nasal cavity, maxillary sinuses, ethmoid cells and orbit upon MRI evaluation [14]. We couldn't do the former at our hospital but imaging was possible and correspond to typical descriptions.…”

Section: Discussionmentioning

confidence: 99%