title: To exenterate or not? An unusual case of pediatric rhinocerebral mucormycosis.
abstract: Rhinocerebral mucormycosis (RM) is a rare, potentially lethal fungal infection. Traditional teaching encourages aggressive surgical resection until viable bleeding tissue is encountered, often leading to orbital exenteration, skull base resection, and cerebral debridement, in addition to systemic antifungal therapy. We present a 2-year-old male with acute lymphocytic leukemia undergoing chemotherapy presenting with RM and unilateral orbital and intracranial involvement. After aggressive sinonasal debridement, systemic antifungal and hyperbaric oxygen therapies, he recovered without need for further aggressive tissue resection. We report the successful management of invasive orbital and intracranial RM without orbital exenteration or cerebral debridement.
authors.affiliation: Wayne State University, Department of Otolaryngology - Head & Neck Surgery, Detroit, MI, USA. Electronic address: smutchnick@med.wayne.edu.
authors.forename: Sean
authors.initials: S
authors.lastname: Mutchnick
authors.affiliation: Wayne State University, Department of Otolaryngology - Head & Neck Surgery, Detroit, MI, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Soares
authors.affiliation: Wayne State University, Department of Otolaryngology - Head & Neck Surgery, Detroit, MI, USA.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Shkoukani
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000382:microbiology* / Q000628:therapy; D002675:Child, Preschool; D003646:Debridement; D006801:Humans; D006931:Hyperbaric Oxygenation; D016867:Immunocompromised Host; D008297:Male; D009091:Mucormycosis / Q000382:microbiology / Q000628:therapy*; D009668:Nose Diseases / Q000382:microbiology* / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma
chemical_list: D000935:Antifungal Agents
keywords: Fungal sinusitis; Infectious; Mucormycosis; Pediatrics; Rhinocerebral; Rhinosinusitis