Combination antifungal therapy without craniotomy in an immunocompromised patient with rhino-orbito-cerebral mucormycosis: A case report

• Main Authors: Mohammad Reza Salehi, Farhad Shahi, Fatema Sadaat Rizvi, Sara Ghaderkhani, Hamed Zainaldain, Sadegh Khodavaysi, Saeed Reza Jamali-Moghaddam, Seyed Ali Dehghan Manshadi, Omid Rezahosseini
• Format: Article
• Language: English
• Published: Babol University of Medical Sciences 2020-03-01
• Series: Caspian Journal of Internal Medicine
• Subjects: mucormycosis; invasive fungal infection; combination drug therapies; liposomal amphotericin b; posaconazole
• Online Access: http://caspjim.com/article-1-1752-en.html
• ISSN: 2008-6164; 2008-6172

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.