Rhino-orbital mucormycosis

Abstract

Purpose of reviewThe current article will update and review the clinical and radiological manifestations and management of rhino-orbital mucormycosis (ROM).Recent findingsThere has been an increase in cases of ROM worldwide, especially in India. Immunosuppression (especially diabetes mellitus) is a known predisposing risk factor for ROM. Delayed diagnosis and treatment of ROM can be vision or life-threatening. This article reviews the clinical and radiologic features, treatment, and prognosis of ROM with special emphasis on new and emerging therapies.SummaryROM is an angioinvasive fungal infection that affects the sinuses and orbits and may present to ophthalmologists. Clinicians should have a high index of suspicion for ROM, especially in patients with poorly controlled diabetes mellitus or other immunosuppression. Corticosteroid treatment (including the recent COVID-19 pandemic) may be a predisposing risk factor for ROM.

Hemorrhagic Fever with Renal Syndrome Complicated with Rhino Mucormycosis: A Case Report

“… 8 Mucormycosis invades the human body, causing infections that progress rapidly and spread to the systemic system, and can involve the central nervous system, orbit, paranasal sinuses, skin, lungs, gastrointestinal tract, and kidneys. 1 , 2 , 9 Patient susceptibility is an important cause of mucor infection. 7 Several factors are associated with susceptibility to mucormycosis.…”

“…Liposomal amphotericin B (LAmB) is the most effective antifungal agent for the treatment of mucormycosis. 9 In addition, posaconazole and isavuconazole are recommended in refractory cases and in patients who are intolerant to prior antifungal agents. 9 However, LAmB has more-toxic side effects, especially hepatotoxicity, and our patient had already developed liver failure; therefore, intravenous systemic use of LAmB was not possible.…”

“… 9 In addition, posaconazole and isavuconazole are recommended in refractory cases and in patients who are intolerant to prior antifungal agents. 9 However, LAmB has more-toxic side effects, especially hepatotoxicity, and our patient had already developed liver failure; therefore, intravenous systemic use of LAmB was not possible. Considering the high mortality rate of MCR, we consulted the relevant data and developed a local treatment plan (case presentation) for MCR taking into consideration the patient ‘s condition.…”

Mucormycosis: update on clinical presentation, diagnosis, and treatment

“…Local instillation of antifungals can sometimes be useful as adjunct therapy or for patients in whom surgery is not an option. Topical and intravitreal AMB may be considered [81]. For patients with trauma associated MCR, AMB irrigation applied with negative pressure has been used [84 ▪ ].…”

“…For patients with trauma associated MCR, AMB irrigation applied with negative pressure has been used [84 ▪ ]. Intraconal irrigation with AMB, surgical packing with gauze soaked in AMB, transcutaneous retrobulbar injection of AMB, or use of local antifungal therapies after more extensive surgical debridement or in patients who are not good surgical candidates at the time can be helpful [81]. Sharifi et al .…”