Our experience of 30 cases of mucormycosis of nose and paranasal sinuses
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20180712Keywords:
Fungi, Mucormycosis, Surgical debridement, Amphotericin BAbstract
Background: Mucormycosis is life threatening fungal infection that occurs in immunocompromised patient. These infections are becoming increasingly common in yet survival remains very poor a great understanding of the pathogenesis of the disease may lead to future therapies.
Methods: In present study we have made an attempt to evaluate a standard method of management of mucormycosis of nose and para nasal sinuses. Total 30 cases of mucormycosis of nose and Para nasal sinuses were studied JIIUS IIMSR Warudi, Badnapur, Jalna a tertiary center from June 2014 to June 2017 thoroughly on the basis of clinical behavior, histopathological report and radiological investigation, we have tried to formulate a standard method of treatment in the form of medical and surgical debridement or combination in order to achieve the best possible results.
Results: In this study male patient were 18 (50%) cases and female were 12 (40%). Most common predisposing factor was diabetes mellitus in 24 (80%) cases and other factors were tuberculosis 4 (13.33) and chronic renal failure 5 (16.66).Most commonly presented age group was 4th decade to 5th decade 11 (36.66) and 8 (26.66%) respectively. Most common symptom was nasal obstruction and sign was maxillary swelling 21 (70%). Most common radiological finding was cloudiness of sinuses 27 (90%) least common finding was intracranial extension 6 (20%). Most common used treatment modalities was amphotericin B24 (80%) and least used was surgical debridement by FESS 16 (53%).
Conclusions: In the management of mucormycosis and its different pathological forms and most aggressive form like rhino cerebral mucormycosis prompt diagnosis based on clinical examination, reversal of predisposing condition and aggressive surgical debridement along with medical treatment remain corner stone of the therapy for this deadly disease.
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References
Blitzer A, Lawson W, Meyer B, Biller HF. Patient survival factor in Para nasal sinus mucormycosis. Laryngoscope. 1980;90:635-48.
Chakrabati A, Das A, Sharma S Panda N, Das S, Gupta KL, et al. Ten years’ experience in zygomycosis at tertiary care center in India. J Infection. 2001;42(4):261-6.
Maniglia AS, Mintz DH, Novak S. Cephalic phycomycosis. A report of eight cases. Laryngoscope. 1982;92:755-60.
Prabhu RM, Patel R. Mucormycosis and Entopthramycosis. A review of the clinical manifestation, a diagnosis and treatment. Clin Microbial Infect. 2004;10:31-4.
Nithyanandan S, Jacob MS, Battu RR, Thomas RR, Correa MA, D’Souza D. Rhino orbito cerebral mucormycosis a retrospective analysis of clinical feature and treatment outcome. Indian J Ophthalmol 2003;51:231-6.
Alobid I, Bernal M, Menendoz L M, Alos L, Benitez P, Mullo J. Sino nasal endoscopic surgery in fungal sinusitis– our experience. Acta Otorhinno. 2002;53:393-7.
Garlapots K, Chavva S, Marshal R, Waddle S, Surampudi J. Fulminant mucormycosis involving Para nasal sinus. Case Rep Dentistry. 2014: 4.
Pillsbury HC, Fischer ND. Rhino cerebral mucormycosis. Arch Otolaryngol. 1977;103:600-4.
Bonza E, Munoz P and Guinea J. Mucormycosis; an emerging disease. Clin Microbiol Infection. 2006;12(7):23.
Sheth SM, Talwalakar NC, Desai AP. Rhino cerebral mucormycosis in a case of renal failure. J Postgrad Med. 1981;27(3):190-3.
Spellberg B, Edwards J, Aibrahim A. Novel perspective on mucormycosis; pathophysiology, presentation and management. Clin Microbiol Rev. 2005;18(3):556-69.