Rhino-orbito-cerebral mucormycosis: Five cases

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• 作者：A. Toumi^a ; ^{adnene_toumi@yahoo.fr} ; F. Larbi Ammari^a ; C. Loussaief^a ; R. Hadhri^b ; H. Ben Brahim^a ; K. Harrathi^c ; F. Ben Romdhane^a ; J. Koubaa^c ; M. Chakroun^a
• 关键词：Mucormycose rhino-orbitocé ; ré ; brale ; Diabè ; te ; Amphoté ; ricine B
• 刊名：Médecine et Maladies Infectieuses
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：42
• 期：12
• 页码：591-598
• 全文大小：743 K

文摘

Introduction and objective

Mucormycosis is an invasive fungal infection usually observed in immunocompromised patients. Mucormycosis is rapidly fatal without an early diagnosis and treatment. We report five patients of rhino-orbital-cerebral mucormycosis and a literature review.

Design

The medical records of five patients presenting with rhino-orbital-cerebral mucormycosis, admitted between January 1995 and December 2007, were analyzed. All patients underwent tissue biopsy. The histologic sections revealed the presence of non-septate hyphae of the order Mucorales.

Results

The five patients, three men and two women, between 27 and 61 years of age, were all diabetic. The main symptoms were exophthalmia (five patients), facial swelling (four patients), periorbital cellulitis (four patients), and cranial nerve palsy (four patients). Anterior rhinoscopy revealed palatine or nasal necrotic lesions in four patients. All presented with diabetic ketoacidosis and CT scan revealed rhino-orbital-cerebral involvement in every patient. All patients were given intravenous amphotericin B. Four patients underwent surgical debridement of necrotic tissue. Two patients survived.

Conclusions

Mucormycosis is usually a fatal infection in diabetic patients. Early diagnosis should be based on imaging data and histology. Amphotericin B must be rapidly initiated and associated with aggressive surgical debridement to reduce mortality.