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Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy
L Couch1, F Theilen, J T Mader
1Department of Internal Medicine, University of Texas Medical Branch, Galveston 77550-2772.
Abstract:
Rhinocerebral mucormycosis is a devastating fungal disease with a high mortality rate. Extensive surgical débridement and amphotericin B are currently the mainstays of therapy. When cerebral extension of the fungus occurs, the disease is almost invariably fatal. Two patients with rhinocerebral mucormycosis had progression of their infection to brain abscesses despite aggressive débridement surgery and amphotericin B therapy. Both patients showed marked clinical improvement with the addition of adjunctive hyperbaric oxygen therapy. Both patients remained free of their disease 21 months after hospital discharge.
Insights
Rhinocerebral mucormycosis, a severe fungal infection, can be fatal when it spreads to the brain. Adjunctive hyperbaric oxygen therapy improved outcomes for two patients with advanced brain abscesses.
Area of Science:
- Mycology
- Infectious Diseases
- Neurosurgery
Background:
- Rhinocerebral mucormycosis is a life-threatening fungal infection.
- Standard treatment involves surgical debridement and amphotericin B.
- Cerebral involvement significantly increases mortality.
Observation:
- Two patients with advanced rhinocerebral mucormycosis developed brain abscesses.
- Infection progressed despite aggressive surgical and antifungal treatments.
Findings:
- Adjunctive hyperbaric oxygen therapy (HBOT) led to marked clinical improvement in both patients.
- Both patients achieved disease-free status 21 months post-discharge.
Implications:
- Hyperbaric oxygen therapy may be a valuable adjunctive treatment for severe rhinocerebral mucormycosis with cerebral extension.
- Further research is warranted to explore HBOT's role in managing invasive fungal infections of the central nervous system.