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Revista de otorrinolaringología y cirugía de cabeza y cuello

versión On-line ISSN 0718-4816


RAHAL E, Maritza; MORENO V, Mauricio  y  VILLA N, Jaime. Rhino-orbital-cerebral mucormycosis: A twelve-year experience. Rev. Otorrinolaringol. Cir. Cabeza Cuello [online]. 2008, vol.68, n.1, pp.27-34. ISSN 0718-4816.

Introduction: Rhino-orbital-cerebral mucormycosis (MROC) is a rare, high mortality infection, produced by fungi belonging to the order Mucorales. It exceptionally affects healthy individuals, being much more prevalent in immunocompromised patients. Aim: To present the 12year experience in mucormycosis at the Barros Luco Trudeau Hospital. Material and Method: This study involves 16 MROC patients that were treatedatthe Barros Luco Trudeau Hospital between 1993 and 2004. We present detailed clinical characteristics of the disease, diagnostic and therapeutic procedures performed, adverse therapy effects and mortality. Results: Only one of the patients was immunocompetent. The most frequent symptom was facial pain and the most frequent finding at physical examination was a black or grayish scab on the nasal mucosa. Direct mycological study was positive in 11 cases, whereas fungal culture was positive in only 10 patients. Of all patients, 15 received combined surgical and intravenous antifungal therapy (amphotericin B). Eleven patients had debridement by open surgery (8 partial and 3 total maxillectomies). Four patients had endoscopic debridement; all of them required more than one procedure. Discussion and Conclusion: Possible causes are discussed as well as the more consistent findings at physical examination and the institution behavior when suspecting a case. In addition, imaging importance, orbital involvement, cutaneous invasion and medical and surgical treatments are discussed. The series survival rate of 62% is underscored

Palabras clave : Mucormycosis; mycological study; amphotericin B.

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