[Rhinocerebral mucormycosis during deferoxamine therapy].
A 24-year-old woman had been in full remission of an acute myeloid leukaemia since 1988, but she required regular erythrocyte and platelet transfusions for pancytopenia. To counteract a progressive siderophilia due to the transfusions (ferritin levels of about 10,000 ng/ml) deferoxamine was intermittently given intravenously (5 g after each transfusion). Seven months after the start of this treatment the patient was hospitalized because of severe left-sided facial pain as well as reddening and swelling in the periorbital region. As maxillary and frontal sinusitis was suspected, antibiotics were administered (at first three times daily 2.2 g amoxicillin and clavulanic acid, then two times daily 300 mg rifampicin and 200 mg ciprofloxacin). Nonetheless, orbital phlegmon developed within a few days with protrusion and blindness of the left eye necessitating a decompression operation. Material obtained at operation revealed rhinocerebral mucormycosis. After 3 weeks of antimycotic treatment with both amphotericin B (1 mg/kg.d) and flucytosine (150 mg/kg.d) the mucormycosis healed without the necessity of extensive and disfiguring removal of necrotic tissue. But the blindness in the left eye, caused by occlusion of the central artery, was irreversible.
Ammon
A
A
Abteilung Hämatologie und Onkologie, Universität Göttingen.
Rumpf
K W
KW
Hommerich
C P
CP
Behrens-Baumann
W
W
Rüchel
R
R
D000328:Adult; D001766:Blindness / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003131:Combined Modality Therapy; D003676:Deferoxamine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy; D009091:Mucormycosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010198:Pancytopenia / Q000188:drug therapy / Q000209:etiology; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012233:Rhizopus; D013997:Time Factors
D003676:Deferoxamine
Rhinozerebrale Mucor-Mykose unter Deferoxamin-Therapie.