title: Multimodal surgical and medical treatment for extensive rhinocerebral mucormycosis in an elderly diabetic patient: a case report and literature review.
abstract: Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB) and posaconazole (PSO) and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient's physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients.
authors: Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
authors: Paola
authors: 0000-0003-4418-5855
authors: P
authors: Di Carlo
authors: Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
authors: Roberto
authors: R
authors: Pirrello
authors: Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
authors: Giuliana
authors: G
authors: Guadagnino
authors: Laboratory of Molecular Endocrinology, Section of Endocrinology, Biomedical Department of Internal and Specialized Medicine (Di.Bi.M.I.S), University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
authors: Pierina
authors: P
authors: Richiusa
authors: Section of Radiology, Di.Bi.Me.F., University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
authors: Antonio
authors: A
authors: Lo Casto
authors: Section of Radiology, "P. Giaccone" Teaching Hospital Palermo, Via del Vespro 127, 90127 Palermo, Italy.
authors: Caterina
authors: C
authors: Sarno
authors: Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
authors: Francesco
authors: F
authors: Moschella
authors: Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
authors: Daniela
authors: D
authors: Cabibi