[Difficulties in the clinical, radiological and therapeutic evaluation of the initial stage of mucormycosis of the rhinosinus].
The initial diagnosis and subsequent treatment of rhino-orbital mucormycoses is quite difficult, particularly because the patient may find it difficult to accept aggressive therapeutic protocols, even when free of any endocranial involvement. The authors draw inspiration from a clinical case of rhino-orbital mucormycosis in a patient suffering from decompensated type I diabetes mellitus to discuss the main clinical-diagnostic and therapeutic aspects of this disorder. Timely medical-surgical treatment proves extremely important for prognosis, preventing the intracranial extension of the lesion which is the cause of death in 80% of such cases. As regards the diagnostic protocol, careful clinical, radiological monitoring with CT and NMR--in strict interdisciplinary cooperation between otorhinolaryngologist, radiologist, ophthalmologist, microbiologist and histopathologist--is especially important. Radical surgery, at times demolition, associated with correction of the metabolic decompensation, systemic therapy with Amphotericin B and localbi-weekly medication for three months constitutes the best therapeutic protocol for treatment of this disorder.
Galli
J
J
Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, Roma.
Di Rienzo
L
L
D'Ecclesia
A
A
Motta
S
S
Di Girolamo
S
S
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009091:Mucormycosis; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D010348:Patient Care Team; D014057:Tomography, X-Ray Computed