Rhinocerebral mucormycosis: evolution of the disease and treatment options.
Rhinocerebral mucormycosis is recognized as a potentially aggressive and commonly fatal fungal infection. The classic presentation is involvement of nasal mucosa with invasion of the paranasal sinuses and orbit. Mucormycosis is most commonly seen in association with diabetic ketoacidosis, but disease demographics have changed with the onset of AIDS and the advent of powerful immunosuppressive drugs. Treatment includes aggressive debridement, systemic antifungal therapy, and control of underlying comorbid factors. Although surgical intervention remains essential, advances in medical therapy have permitted a more limited surgical approach to minimize functional loss without compromising survival. We present the UCLA experience with rhinocerebral mucormycosis from 1955 to 1995, with emphasis on the evolution of disease presentation and alternative treatment options.
Peterson
K L
KL
Division of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California 90095-1624, USA.
Wang
M
M
Canalis
R F
RF
Abemayor
E
E
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D003646:Debridement; D016883:Diabetic Ketoacidosis / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis* / Q000601:surgery; D009297:Nasal Mucosa / Q000382:microbiology; D009668:Nose Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D009894:Opportunistic Infections / Q000175:diagnosis; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B