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Rhinoorbital mucormycosis in the immunocompetent: Experience with Isavuconazole
Marta Ilharco1, Carla Maravilha Pereira1, Laura Moreira1
1Department of Internal Medicine 1.4, Hospital de S. José - Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
Idcases
|August 28, 2019
Summary
This case study highlights a rare instance of mucormycosis in an immunocompetent individual. Prompt diagnosis and multi-modal treatment, including surgery and antifungals, led to a successful recovery.
Area of Science:
- Mycology
- Infectious Diseases
- Ophthalmology
Background:
- Mucormycosis is a severe fungal infection caused by Mucorales, often associated with immunosuppression.
- While rare, mucormycosis can affect immunocompetent individuals, presenting diagnostic challenges.
Observation:
- A 61-year-old immunocompetent male presented with ocular pain, initially misdiagnosed as conjunctivitis.
- Fungal elements of Zygomycetes were identified in a biopsy after surgical debridement.
Findings:
- The patient received a combination therapy including Liposomal Amphotericin B (LAmB), Posaconazole, and later Isavuconazole due to bicytopenia.
- Hyperbaric oxygen therapy was also administered, contributing to positive outcomes.
Implications:
- This case underscores the importance of considering mucormycosis in immunocompetent patients with severe ocular infections.
- Successful management involved a multidisciplinary approach combining surgical intervention, targeted antifungal therapy, and adjunctive treatments like hyperbaric oxygen.
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