Orofacial infection by Conidiobolus coronatus.
Entomophtoramycosis is a type of subcutaneous mycosis which includes both basidiobolomycosis and conidiobolomycosis; the latter is caused by Conidiobolus coronatus, a saprophytic fungus which lives in tropical soils. This mycosis characteristically affects the paranasal sinuses and oropharynx, with the potential to deform the face in patients without apparent immunodeficiency. It has a chronic course of infection with a tendency to form granulomas visible using histology. We present the case of a 28 year-old male agricultural worker, with a clinical profile of 6 months' evolution of rhinofacial tumefaction, nasal obstruction and post-nasal drip who was diagnosed with conidiobolomycosis by means of tissue culture after multiple biopsies of the facial area. The patient received antifungal treatment with amphotericin B and subsequently with itraconazol, resulting in a dramatic improvement without the need for surgical treatment; itraconazol was administered for one year and there was no evidence of relapse at the end of this period. Due to the low frequency of this disease there is no established treatment strategy; however, the use of azoles such as itraconazol with or without adjuvant surgical treatment is increasingly seen in case reports. The present report adds to the clinical experience in Colombia of this rare mycosis and also describes the long-term clinical and therapeutic response.
Servicio de Medicina Interna, Universidad Pontificia Bolivariana, Medellín, Colombia. dianacmoncada@yahoo.es.
Diana Carolina
DC
Moncada
Melisa
M
Montes
Verónica
V
Molina
Jorge Byron
JB
Velásquez
Carlos Ignacio
CI
Gómez
D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001706:Biopsy / Q000592:standards; D020092:Conidiobolus / Q000187:drug effects*; D003881:Dermatomycoses / Q000503:physiopathology*; D005145:Face / Q000503:physiopathology*; D006099:Granuloma / Q000503:physiopathology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B
Colombia.; Conidiobolus; case reports; itraconazole