A Case of Rhinoorbital Mucormycosis in a Leukemic Patient with a Literature Review from Turkey |
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Authors: | Email author" target="_blank">Ramazan?GumralEmail author Uzeyir?Y?ld?zoglu Mehmet?Ali?Saracli Kursat?Kaptan Fuat?Tosun Sinasi?Taner?Yildiran |
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Institution: | (1) Department of Microbiology, Gulhane Military Medical Academy, Ankara, Turkey;(2) Department of Ears Nose Throat, Gulhane Military Medical Academy, Ankara, Turkey;(3) Department of Haematology, Gulhane Military Medical Academy, Ankara, Turkey |
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Abstract: | Mucormycosis (Zygomycosis) is a rare, invasive, opportunistic fungal infection of the paranasal sinuses, caused by a fungus
of the order Mucorales. We report a case of rhinoorbital mucormycosis caused by Rhizopus
oryzae in an acute lymphoblastic leukemia patient and review the 79 Mucormycosis cases reported in the last decade from Turkey.
In our case, the diagnosis was made with endoscopic appearance, computerized tomography of the paranasal sinuses, and culture
of the surgical materials. Following aggressive surgical debridement and parenteral amphotericin B therapy, the patient recovered
completely. In Turkish literature, rhinocerebral manifestations were the most common form of the mucormycosis (64 cases),
followed by pulmonary form (6 cases). The most common risk factor was hematologic malignancies (32 cases) and diabetes mellitus
(32 cases), similar to those reported from the rest of the world. The etiologic agents responsible for the review cases were
Rhizopus sp., Mucor spp., Rhizomucor spp., Rhizopus
oryzae, Mucor
circinelloides, and Lichtheimia corymbifera. Although various treatment modalities were used, amphotericin B was the mainstay of therapy. Mortality rate was found to
be 49.4% in review cases. It seems that strong clinical suspicion and early diagnosis, along with aggressive antifungal therapy
and endoscopic sinus surgery, have great importance for better prognosis in mucormycosis. |
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