Mucormycosis--early diagnosis and treatment.
OBJECTIVE
The aim of this retrospective study was to analyse the data of patients with rhino-orbital-cerebral mucormycosis for predisposing factors, diagnosis, treatment and survival rate. The role of frozen section in early diagnosis and use of nasal endoscopy in diagnosis, treatment and follow-up of patients has also been examined.


METHODS
Retrospective case series.


METHODS
University Teaching Hospital.


METHODS
The case notes of 9 patients with diagnosis of mucormycosis who presented from 1973 to 2001 were examined. The data for predisposing factors, signs/symptoms, histological diagnosis, radiological intervention, medical and surgical treatment and final outcome was analysed.


RESULTS
There were 9 patients with mucormycoses. Early diagnosis was made by endoscopic examination and frozen section in 5 patients, which was later confirmed by histology. Treatment included parental and/or local amphotericin, hyperbaric oxygen and debridement either by endoscopic or external approach, with or without orbital exenteration. This resulted in an overall survival of 5 patients.


CONCLUSIONS
Frozen section diagnosis allows for early therapy since successful treatment depends on systemic amphotericin, surgical debridement and treatment of underlying predisposing factors. Nasal endoscopy is useful in diagnosis, endoscopic debridement and follow up of patients.
Hospital Pasteur, ENT Department, Surgery of the Face and Neck, 30 avenue de la Romaine, BP 69, F-06002 Nice 1, France. Nicolas.guevara@wanadoo.fr
N
N
Guevara
D
D
Roy
C
C
Dutruc-Rosset
J
J
Santini
P
P
Hofman
L
L
Castillo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D003646:Debridement; D004724:Endoscopy; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D009668:Nose Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D012189:Retrospective Studies
D000935:Antifungal Agents; D000666:Amphotericin B