amphotericin-b and Paranasal-Sinus-Neoplasms

Topics: Amphotericin B; Animals; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Blepharoptosis; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Diagnosis, Differential; Ethmoid Sinusitis; Humans; Immunocompromised Host; Male; Maxillary Sinusitis; Nasal Mucosa; Orbit; Osteolysis; Paranasal Sinus Neoplasms; Radiography

A rare case of rhinocerebral mucormycosis occurred in a 74-year-old diabetic male with gradually progressive right visual loss and total ophthalmoplegia. Computed tomography and magnetic resonance imaging revealed an invasive right orbital apex mass, destroying the medial wall of the orbit and extending into the right cavernous sinus and right middle fossa. Laboratory data demonstrated no signs of inflammation. A carcinomatous lesion originating in the paranasal sinuses and extending into the intracranial space was diagnosed. The mass was totally removed through a subfrontal approach to confirm the histological diagnosis and decompress the optic nerve. The histological diagnosis was mucormycosis. Despite aggressive medical therapy, dissemination resulted in mucor pleuritis and mucor encephalitis or meningitis. He died of septic shock and acute renal failure.

Topics: Aged; Amphotericin B; Brain Diseases; Cavernous Sinus; Diagnosis, Differential; Ethmoid Sinus; Humans; Magnetic Resonance Imaging; Male; Mucormycosis; Orbital Diseases; Paranasal Sinus Neoplasms; Tomography, X-Ray Computed

Rhinocerebral mucormycosis (phycomycetes), a human fungal disease with oral and perioral findings, has an extremely high morbidity and mortality. The disease is most frequently seen in patients with poorly controlled diabetes. The symptoms, findings, and treatment of rhinocerebral mucormycosis are discussed, and two case histories are presented.

Topics: Adult; Amphotericin B; Blepharoptosis; Cellulitis; Diagnosis, Differential; Eye Diseases; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mucormycosis; Nose Diseases; Ophthalmoplegia; Orbit; Palatal Neoplasms; Palate; Paranasal Sinus Neoplasms; Paresthesia; Radiography; Sinus Thrombosis, Intracranial; Ulcer; Vision Disorders