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Combination Antifungal Therapy Without Craniotomy in an Immunocompromised Patient With Rhino-Orbito-Cerebral Mucormycosis: A Case Report Publisher



Salehi M1 ; Shahi F2 ; Rizvi FS3 ; Ghaderkhani S1 ; Zainaldain H3 ; Khodavaisy AS4 ; Jamalimoghaddam SR5 ; Manshadi SAD1 ; Rezahosseini O1, 6
Authors
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Authors Affiliations
  1. 1. Imam Khomeini Complex Hospital, Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Adult Hematology and Oncology, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Medical Mycology and Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Ziaeian Hospital, Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Source: Caspian Journal of Internal Medicine Published:2020


Abstract

Background: Mucormycosis is an uncommon fungal infection caused by the members of the order Mucorales. In susceptible patients, mucormycosis can infect any tissue or organ, and without suitable treatment (i.e., debridement and antifungal therapy), this infection can be fatal. Our patient was a woman with lymphoma and cerebral mucormycosis who was treated with antifungals and without any neurosurgical debridement. Case Presentation: Herein, we present the case of a 35-year-old woman with diagnosis of B-cell lymphoma and rhino-orbito-cerebral mucormycosis (ROCM). She was a candidate for enucleation of the left eye, orbital decompression, and sinocerebral debridement. Nevertheless, the patient refused eye enucleation and craniotomy. Finally, she was treated with a combination of antifungals and sinus debridement without eye enucleation and craniotomy. Conclusion: Endoscopic debridement, along with a combination of liposomal amphotericin B (LAMB) and posaconazole, may be a suitable therapeutic option for patients with ROCM, who are not eligible candidates for extensive surgery or craniotomy. © 2020 Caspian Journal of Internal Medicine. All rights reserved.