Local application of antimycotics in mucormycosis cerebri: a case report.

Mohsenipour, I; Schirmer, Michael; Frank, R; Geisen, Francoise; Semenitz, E; Nedden, Dieter zur; Konwalinka, G

doi:10.1136/jnnp.61.5.521

Cited by 7 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From a safety standpoint, we chose a 0.05 mg/mL solution based on clinical experience in use for bladder irrigation [ 11 ]. Additionally, higher concentrations have been applied directly to brain tissue without apparent toxicity [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Beaver

Garza

Vallabhaneni

et al. 2021

Medical Mycology Case Reports

View full text Add to dashboard Cite

The standard of care for treatment of sino-orbital mucormycosis involves aggressive surgical debridement and liposomal amphotericin, and the roles of adjunctive and topical therapies are less clear. Here we describe a case of severe refractory sino-orbital mucormycosis in an immunocompetent patient who responded to combination therapy with liposomal amphotericin, isavuconazole, micafungin, and topical amphotericin deoxycholate after failing to achieve negative surgical margins.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Beaver

Garza

Vallabhaneni

et al. 2021

Medical Mycology Case Reports

View full text Add to dashboard Cite

show abstract

“…Rhinocerebral mucormycosis, the most common subtype, occurs predominantly in diabetics who have had recurrent bouts of severe ketoacidosis [7]. Although long‐term survival and cure of rhinocerebral mucormycosis has been reported in recent years, it is disputed whether surgical treatment should be performed before biopsy specimens are obtained [6,8–10]. A survey of the literature during the period from 1955 to 2006 reveals that patients who were treated conventionally without surgical intervention had the poorest outcome, even though the timing of surgical intervention did not seem to play a significant role [5].…”

Section: Discussionmentioning

confidence: 99%

Early diagnosis of rhinocerebral mucormycosis by cerebrospinal fluid analysis and determination of 16s rRNA gene sequence

Bengel

Šuša

Schreiber

et al. 2007

Euro J of Neurology

View full text Add to dashboard Cite

A 40-year-old diabetic woman was diagnosed with rhinocerebral mucormycosis. Cerebral mucormycosis is an acute life-threatening disease, which is caused by fungi of the class Phycomycetae. Clinical suspicion and detection of the fungal hyphae in cerebrospinal fluid (CSF) led to early diagnosis, subsequently confirmed by immunohistochemistry and molecular analysis of fungal RNA. Early infiltration of the infectious agent into the central nervous system resulted in septic thrombosis of the cavernous sinus, mycotic meningoencephalitis, brain infarctions as well as intracerebral and subarachnoidal hemorrhages. Despite immediate high-dose antimycotic treatment, surgical debridement of necrotic tissue, and control of diabetes as a predisposing factor, the woman died 2 weeks after admission. Although fungal organisms are rarely detectable in CSF specimens from patients with mycotic infections of the central nervous system, comprehensive CSF examination is beneficial in the diagnosis of rhinocerebral mucormycosis. Furthermore, a concerted team approach, systemic antifungal agents and early surgical intervention seem to be crucial for preventing rapid disease progression.

show abstract

“…There are different methods to administer antifungal treatment intracerebrally. There have been reported some cases successfully treated by utilizing absorbable gelatin sponges impregnated with amphotericin B (23, 25). Another method employed a wound canula to administer amphotericin B into the wound cavity (26).…”

Section: Discussionmentioning

confidence: 99%

“…Four days post‐surgery intrathecal instillation of amphotericin B deoxycholate was initiated, starting with 0.1 mg/d (19–24). At that time the presumed mycotic abscesses in the lung had dramatically decreased in size following systemically administered amphotericin B. Eleven days after surgery the patient's condition permitted continuation of cytostatic therapy.…”

Section: Case Reportmentioning

confidence: 99%

Successful treatment of invasive mould infection affecting lung and brain in an adult suffering from acute leukaemia

Buxhofer¹,

Ruckser²,

Kier³

et al. 2001

European J of Haematology

View full text Add to dashboard Cite

We describe in detail a 67-yr-old woman who was treated with a cytostatic combination chemotherapy for newly diagnosed common-acute lymphoblastic leukaemia. At the end of induction therapy, the patient acquired invasive mould infection affecting lung and brain. The patient entered complete remission of her leukaemia. Treatment with liposomal amphotericin B was initiated along with surgical excision of the fungal brain abscess. Intrathecal instillation of amphotericin B deoxycholate was started using an Ommaya reservoir because of an anatomical connection between the postoperative cavity and the ventricle. Full dose cytostatic chemotherapy was continued with little delay. A computerised tomography scan of the chest performed 2 months later revealed no fungal abscesses. Magnetic resonance imaging of the brain did not reveal any fungal manifestation. During maintenance therapy/week 69, the patient relapsed from leukaemia. High doses of intravenous liposomal amphotericin B were administered prophylactically. The patient's leukaemia proved refractory to reinduction chemotherapy and the patient died from pneumonia 8 wk later. Post mortem microbiological investigation and histopathological examination of lung and brain tissue did not reveal any macroscopical or microscopical fungal manifestations. This case underlines the feasibility and successful application of combined antileukaemic, antifungal and surgical therapy in a patient with acute leukaemia.

show abstract

Local application of antimycotics in mucormycosis cerebri: a case report.

Cited by 7 publications

References 8 publications

Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Early diagnosis of rhinocerebral mucormycosis by cerebrospinal fluid analysis and determination of 16s rRNA gene sequence

Successful treatment of invasive mould infection affecting lung and brain in an adult suffering from acute leukaemia

Contact Info

Product

Resources

About