Intraconal amphotericin B for the treatment of rhino-orbital mucormycosis

Ophthalmic Surg Lasers. 1996 Aug;27(8):706-8.

Abstract

Rhino-orbital-cerebral mucormycosis is a disease that is frequently fatal. A 39-year-old man with diabetic ketoacidosis was referred to the authors' ophthalmic service with fever, orbital apex syndrome in the right eye, lethargy, and a black eschar in the palate. He was treated with systemic and local (intraconal) amphotericin B and his ketoacidosis was controlled; exenteration was not performed. Biopsy of the palate proved mucormycosis. Eighteen months later the patient was still alive and had a blind, anatomically preserved right eye with ptosis and intact extraocular muscle function without proptosis or pain. The authors propose this alternative means of treatment to achieve higher doses of the drug at the site of infection and better cosmetic and psychological results.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Biopsy
  • Diabetic Ketoacidosis / complications
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / etiology
  • Humans
  • Male
  • Mucormycosis / diagnosis
  • Mucormycosis / drug therapy*
  • Mucormycosis / etiology
  • Orbit / drug effects*
  • Orbital Diseases / diagnosis
  • Orbital Diseases / drug therapy*
  • Orbital Diseases / microbiology
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / drug therapy*
  • Paranasal Sinus Diseases / microbiology
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents
  • Amphotericin B