Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature

Elinav, Hila; Zimhony, Oren; Cohen, Marc; Marcovich, Arie; Benenson, Shmuel

doi:10.1111/j.1469-0691.2009.02884.x

Cited by 62 publications

(50 citation statements)

References 66 publications

(75 reference statements)

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“…It occurs as a rare complication in patients with diabetic acidosis, in drug addiction, and in patients with leukemia and lymphoma, particularly those treated with corticosteroids and cytotoxic agents, severe burns, cirrhosis, severe dehydration, asthma, nephrotic syndrome, necrotizing gingivitis (1-13). Some of the cases have no predisposing factors (14,15). Aplastic anemia and acute myeloblastic leukemia were the predisposing factors in our cases.…”

Section: Discussionmentioning

confidence: 90%

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Rhinocerebral Mucormycosis

YILDIZ¹

2012

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Rinoserebral mukormikozis nadir görülen, ilerleyici ve ölümcül olabilen oportunistik fungal bir infeksiyondur. Yüksek mortalite ve morbiditeye sahiptir. Erken tanı, medikal ve cerrahi tedavi prognozun düzelmesi için önemlidir. Biz, predispozan faktörü aplastik anemi ve akut myeloblastik lösemi olan iki olgu sunduk. Mukormikozis, olgularımızın etkilenen gözünde oküler hareketlerde bozulmaya, propitozise, kemozise ve hiperemiye neden olmuștur. Ayrıca ilk olgumuzda mukormikozis nedeni ile trigeminal sinirin birinci ve ikinci dalıda etkilenmiștir. Her iki olgumuzda da mukormikozis infeksiyonu histopatolojik olarak doğrulanmıștır. İlk olgumuzun manyetik rezonans görüntülemesinde sol taraftaki maksiller, sfenoid ve etmoid sinuste yumușak doku artıșı ve etkilenen bölge çevresindeki dura ve ekstraokuler kaslarda kontrast tutulumu mevcuttur. İkinci olgunun orbitofrontal bilgisayarlı tomografisinde sol frontal, maksiller, etmoid ve sfenoid sinuste radio-opasite ve sol etmoid sinusun kemik duvarında delikli destruksiyon vardır. Her iki olgumuzda antifungal tedavi verilmesine rağmen ölmüștür. Mukormikozisin bașarılı tedavisi için erken tanı, altta yatan predispozan risk faktörün düzelebilir olması, cerrahi debridman ve erken antifugal tedavi gerekmektedir.Anahtar Sözcükler: Rinoserebral mukormikozis, oküler palsi, presdispozan faktör, erken tanı, antifungal tedavi Rhinocerebral mucormycosis is a rare, progressive and fatal opportunistic fungal infection. It has high morbidity and mortality. Early diagnosis, medical and surgical management is necessary for improving prognosis. We reported two cases. Aplastic anemia and acute myeloblastic leukemia were predisposing factors in our cases. Mucormycosis caused ocular movement disorders, amaurosis, proptosis, chemosis and hyperemia on the affected eye in our cases. Furthermore, the first case had trigeminal palsy involving first and second divisions of the nerve due to mucormycosis. We confirmed mucormycosis infection with histopathological examination in both cases. In our first case, magnetic resonans imaging revealed increase of soft tissues in the maxillary, sphenoid and ethmoid sinuses and contrast-enhancement of dura around the affected area and of extraocular muscles on the left side. Orbitoparanasal computed tomography of the second case revealed radiopacity involving the left frontal, maxiller, ethmoid, sphenoid sinuses and spotty destruction of bony walls of the left ethmoid sinus. Although we gave prompt antifungal therapy in both cases, they died. Successful treatment of mucormycosis requires early diagnosis, reversal of underlying predisposing risk factors, surgical debridement and prompt antifungal therapy.

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Section: Discussionmentioning

confidence: 90%

“…Zygomycetes location involves the cavernous sinus with the presentation of facial pain, cranial nerve palsies (cranial nerves III, IV, V and VI), proptosis and edema of the lids and retina (1,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Palatal ulcer was reported with rhinocerebral mucormycosis in literature (9).…”

Section: Discussionmentioning

confidence: 99%

Rhinocerebral Mucormycosis

YILDIZ¹

2012

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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“…Management of Rhino-orbitocerebral mucormycosis consists of early surgery and antifungal agents, preferably parenteral Amphotericin B. While Posaconazole is reported to be as an alternative, other anti-fungals like Caspofungin and Voriconazole have limited use in treating mucormycosis [15].…”

Section: Discussionmentioning

confidence: 99%

Rhino-Orbito-Cerebral Mucormycosis: Neglected Mycoses in Childhood Malignancies

Alemayehu¹

2017

Virol Mycol

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“…A review of the literature on cases of rhinocerebral mucormycosis without predisposing factors disclosed a higher than expected prevalence of 9%, with a mortality rate (47%) similar to that of cases having predisposing factors. The most common presentation was rhinocerebral (44%), followed by isolated sinus (37%) and sino-orbital (18%) [18].…”

Section: Epidemiologymentioning

confidence: 99%

Mucormycosis of the Head and Neck

Dan

2011

Curr Infect Dis Rep

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Mucormycosis of the head and neck is the most common form of infection by the order Mucorales, accounting for up to half of all cases. About 70% of rhinocerebral cases develop in diabetic patients. Less often, rhinocerebral mucormycosis occurs in solid organ transplant recipients, those with prolonged neutropenia, and those on deferoxamine therapy. Recently, rhinocerebral disease has been increasingly recognized in patients undergoing hematopoietic stem cell transplantation. A growing number of cases have presented as breakthrough infection in patients receiving voriconazole. The mortality rate of rhinocerebral mucormycosis has remained at 30% to 70% despite aggressive therapy. Early initiation of treatment substantially improves outcome, underscoring the need to maintain a high index of suspicion and promptly biopsy potential lesions. Surgical excision of necrotic tissue is essential. Lipid formulations of amphotericin B have become the standard treatment for mucormycosis. Posaconazole is useful as salvage therapy, but cannot be recommended yet as primary therapy.

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Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature

Cited by 62 publications

References 66 publications

Rhinocerebral Mucormycosis

Rhinocerebral Mucormycosis

Rhino-Orbito-Cerebral Mucormycosis: Neglected Mycoses in Childhood Malignancies

Mucormycosis of the Head and Neck

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