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Emerging therapeutic options in fulminant invasive rhinocerebral mucormycosis

Kathrin Scheckenbach1, Oliver Cornely, Thomas K Hoffmann

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, Düsseldorf, Germany. scheckenbach@med.uni-duesseldorf.de

Auris, Nasus, Larynx
|October 28, 2009
PubMed
Abstract

Insights

Rhinocerebral mucormycosis (RCM) is a challenging fungal infection often diagnosed late. Posaconazole shows promise as an effective treatment alternative for RCM.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Rhinocerebral mucormycosis (RCM) is a rare, aggressive fungal infection.
  • Predisposing factors include diabetes mellitus and immunosuppression.
  • Nonspecific symptoms and unimpressive initial CT scans delay diagnosis.

Observation:

  • Five cases of RCM with varied clinical courses and outcomes are presented.
  • Diagnosis often requires histopathological confirmation due to subtle early signs.
  • Progressive disease can lead to rapid orbital and cerebral invasion.

Findings:

  • RCM presents a significant diagnostic and therapeutic challenge.
  • Systemic posaconazole demonstrated effectiveness, potentially surpassing amphotericin B.
  • Prompt management of underlying conditions, surgical debridement, and antifungal therapy are crucial.

Implications:

  • Early recognition and intervention are vital for improving RCM patient outcomes.
  • Posaconazole represents a valuable therapeutic option in RCM management.
  • Multidisciplinary approaches are essential for combating this fulminant infection.

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