Rhinocerebral mucormycosis: the disease spectrum in 27 patients

Abstract

The variable forms of clinical complaints, findings and time interval of presentation in 27 cases of mucormycosis have been described, which were encountered over a span of 8 years. The previous concept about this fungal infection attacking chronic, debilitated, immunocompromised patients does not appear to hold true. Seven of the 27 patients (22.2%) did not reveal any predisposing factors and their outcome of 42.9% survival seems to be poorer than the total outcome (66.7%). 'Chronic form' of disease presentation, the definition of which is still not delineated, was encountered in four patients (14.8%). Again, the outcome was not significantly different from the total survival. Burr-hole tap of an intracranial abscess revealing mucor in a 2-month-old infant has been described. Even in the present era, extranasal exenteration of sinuses along with disfiguring orbital exenteration is required to ensure satisfactory surgical debridement. Control of the underlying predisposing illness, along with the aggressive surgical debridement and the parenteral administration of amphotericin B, remains the treatment essentials even today.

Brain abscess: surgical experiences of 162 cases

“…[15,16] Cultures for acid-fast bacilli and fungi should be conducted in all cases as occasionally, intracranial tuberculosis as well as fungal infections can present as an abscess. [17][18][19][20] In our series, majority of the culture failed to show positive bacterial growth. More than one-third of otogenic and metastatic abscesses are polymicrobial (aerobic and/or anaerobic).…”

Mucormycosis—A Possible Trigger Pathogen for Encapsulating Peritoneal Sclerosis

“…It is possible that mucormycosis may have remained in a dormant or chronic form in the peritoneum as has often occurred in reported cases involving intracranial and maxillofacial sources (9). Chronic exposure to mucormycosis pyogens in the subsequent few months, together with underlying predisposing factors such as long duration on PD, prior bacterial infections, and discontinuation of PD, may have led to the rapid development of EPS.…”

Mucormycoses

“…Comme de nombreuses études l'ont montré, l'association d'une prise en charge chirurgicale à une prise en charge médicale améliorerait le pronostic des patients. Une revue monocentrique de 27 cas de mucormycoses rhino-orbito-cérébrales traitées entre 1997 et 2005 a montré que le délai de prise en charge chirurgicale était également primordial avec un taux de survie de 79 % (11 patients sur 14) pour les patients opé-rés dans les 2 semaines suivant l'apparition de la symptomatologie contre 54 % (7 patients sur 13) pour ceux chez qui la prise en charge chirurgicale avait été différée [12].…”