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Paranasal sinus mucormycosis: a report of two cases
1Department of Otorhinolaryngology, Kuopio University Hospital, Finland. pirkko.ruoppi@kuh.fi
Abstract:
Mucormycosis of the nose and paranasal sinuses is a rare invasive fungal infection, which often has a very fulminant course and characteristic clinical findings. The patients are usually immunocompromised, with diabetic ketoacidosis being the commonest underlying disorder. In some immunocompetent patients, the disease is associated with local predisposing factors, such as chronic sinusitis. Although the prognosis has improved in recent decades, the disease can still be fatal. The underlying disease is an important determinant of prognosis and correction of the metabolic disorder, if present, is essential. Herein we report two cases: one of our patients was immunocompetent but had earlier suffered from polypous rhinosinusitis whereas the other had mild adult-type diabetes. Both patients were successfully treated with surgical debridement and amphotericin B.
Insights
Nasal mucormycosis is a rare fungal infection, often fatal, affecting immunocompromised individuals. Successful treatment involves surgical debridement and amphotericin B, even in some immunocompetent patients with predisposing factors.
Area of Science:
- Mycology
- Infectious Diseases
- Otolaryngology
Background:
- Mucormycosis of the nose and paranasal sinuses is a rare, aggressive fungal infection.
- It predominantly affects immunocompromised individuals, often linked to diabetic ketoacidosis.
- Local factors like chronic sinusitis can predispose even immunocompetent individuals.
Observation:
- Two cases are presented: one immunocompetent patient with prior polypous rhinosinusitis, and one with mild adult-type diabetes.
- Both cases exhibited the characteristic fulminant course of sinonasal mucormycosis.
Findings:
- Successful treatment was achieved through surgical debridement and administration of amphotericin B.
- Correction of underlying metabolic disorders is crucial for improving prognosis.
Implications:
- This highlights the importance of prompt diagnosis and aggressive management of sinonasal mucormycosis.
- Effective treatment strategies, including surgery and antifungal therapy, can lead to favorable outcomes even in complex cases.