Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review
Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal the...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/527062 |
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| author | Paola Di Carlo Roberto Pirrello Giuliana Guadagnino Pierina Richiusa Antonio Lo Casto Caterina Sarno Francesco Moschella Daniela Cabibi |
| author_facet | Paola Di Carlo Roberto Pirrello Giuliana Guadagnino Pierina Richiusa Antonio Lo Casto Caterina Sarno Francesco Moschella Daniela Cabibi |
| author_sort | Paola Di Carlo |
| collection | DOAJ |
| description | Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB) and posaconazole (PSO) and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients. |
| format | Article |
| id | doaj-art-44ac002212234adc934a18bd28702f1d |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-44ac002212234adc934a18bd28702f1d2025-02-03T01:32:56ZengWileyCase Reports in Medicine1687-96271687-96352014-01-01201410.1155/2014/527062527062Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature ReviewPaola Di Carlo0Roberto Pirrello1Giuliana Guadagnino2Pierina Richiusa3Antonio Lo Casto4Caterina Sarno5Francesco Moschella6Daniela Cabibi7Department of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Via del Vespro 127, 90127 Palermo, ItalyPlastic and Reconstructive Surgery, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Via del Vespro 127, 90127 Palermo, ItalyLaboratory of Molecular Endocrinology, Section of Endocrinology, Biomedical Department of Internal and Specialized Medicine (Di.Bi.M.I.S), University of Palermo, Via del Vespro 127, 90127 Palermo, ItalySection of Radiology, Di.Bi.Me.F., University of Palermo, Via del Vespro 129, 90127 Palermo, ItalySection of Radiology, “P. Giaccone” Teaching Hospital Palermo, Via del Vespro 127, 90127 Palermo, ItalyPlastic and Reconstructive Surgery, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Sciences for Health Promotion and Mother-Child Care “G. D’Alessandro”, University of Palermo, Via del Vespro 127, 90127 Palermo, ItalyDiabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB) and posaconazole (PSO) and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients.http://dx.doi.org/10.1155/2014/527062 |
| spellingShingle | Paola Di Carlo Roberto Pirrello Giuliana Guadagnino Pierina Richiusa Antonio Lo Casto Caterina Sarno Francesco Moschella Daniela Cabibi Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review Case Reports in Medicine |
| title | Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review |
| title_full | Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review |
| title_fullStr | Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review |
| title_full_unstemmed | Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review |
| title_short | Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review |
| title_sort | multimodal surgical and medical treatment for extensive rhinocerebral mucormycosis in an elderly diabetic patient a case report and literature review |
| url | http://dx.doi.org/10.1155/2014/527062 |
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