title: Chronic rhino-orbito-cerebral mucormycosis: A case report and review of the literature.
abstract: Mucormycosis is a life-threatening disease, were rhinocerebral infection is most commonly seen in the clinical setting. Chronic mucormycosis is a rare presentation that exhibits a challenging diagnosis. We describe the case of a 47 year old diabetic man with complains of left zygomatic arch swelling of 3 months evolution. He had received previous antibiotic treatment without improvement. Biopsy of maxillary sinus revealed the presence of non-septated, 90° angle branched hyphae compatible with zygomicetes. The patient was treated with surgical debridement and amphotericin B until there was no evidence of fungi in the tissue by biopsy. We reviewed chronic rhino-orbito-cerebral mucormycosis from 1964-2014 and 22 cases were found, being this the second case of chronic mucormycosis reported in Mexico. A quarter of the cases were seen in immunocompetent hosts. As only 20% of the causal agent can be isolated by culture, the diagnosis is mainly made by biopsy. Besides treatment with amphotericin B, posaconazole as alternative, and control of the underlying comorbidities, surgical debridement represents the corner stone therapy. We recommend at least 36 month follow-up, due to the 13% risk of recurrence. A chronic presentation has a general survival rate of approximately 83%.
authors.affiliation: Infectious Diseases Division, Internal Medicine Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Gutiérrez-Delgado
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP, 64460, NL, Mexico.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Treviño-González
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP, 64460, NL, Mexico.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Montemayor-Alatorre
authors.affiliation: Pathology Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Luis Angel
authors.initials: LA
authors.lastname: Ceceñas-Falcón
authors.affiliation: Pathology Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ruiz-Holguín
authors.affiliation: Internal Medicine Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Catalina Janette
authors.initials: CJ
authors.lastname: Andrade-Vázquez
authors.affiliation: Infectious Diseases Division, Internal Medicine Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Lara-Medrano
authors.affiliation: Infectious Diseases Division, Internal Medicine Department, University Hospital "Dr. José Eleuterio González" of the Autonomous University of Nuevo León, Gonzalitos Y Madero SN, Mitras Centro, Monterrey, CP 64460, NL, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Ramos-Jiménez
keywords: Amphotericin; Chronic mucormicosis; Mucoraceae; Rhino-orbito-cerebral; Rhinocerebral mucormicosis