[Forefront of diagnosis and treatment of deep-steam mycology in Korea--rhinoorbitocerebral zygomycosis].
Mucor is a mold which exists in nature, but mucor infections of humans, even in immunocompromised hosts, are rare. Clinical manifestations of mucormycosis are nonspecific and diagnosis is based on microscopic examination and culture of biopsy specimens. Serologic test or molecular methods of speciation are used only as research tools. We investigated medical records especially for underlying diseases, clinical findings, treatment, and prognosis of patients diagnosed with rhinocerebral mucormycosis retrospectively in the Asan Medical Center. The underlying diseases were diabetes mellitus in 8 patients, acute leukemia in 2, kidney transplantation in 2, and myelodysplastic syndrome in 1 of the total 13 patients. Six patients complained of nasal symptoms including stuffy nose, rhinorrhea, 5 patients complained of ophthalmic symptoms such as decreased visual acuity, diplopia, and ophthalmic pain and 2 of hard palate ulcer. The mortality was 23%(3/13; the two patients with kidney transplant, and one patient with acute leukemia). In summary, mucormycosis should be considered in an uncontrolled DM and an immunocompromised host. The combined modality of early surgical debridement and antifungal agents was used for better treatment of rhinocerebral mucormycosis.
Lee
Eun Jung
EJ
Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center.
Chung
Jin-Won
JW
Choi
Sangho
S
Kim
Yang Soo
YS
Woo
Jun Hee
JH
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003646:Debridement; D003920:Diabetes Mellitus; D003937:Diagnosis, Differential; D019337:Hematologic Neoplasms; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D009668:Nose Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D009916:Orbital Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016377:Organ Transplantation; D020096:Zygomycosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
D000935:Antifungal Agents