Managing Rhino-cerebral Mucormycosis: Institutional Experience

Abstract

Introduction
 Rhinocerebral mucormycosis is a rapidly progressive life threatening opportunistic fungal disease and usually occurs in individuals with weakened immune system. It is caused by filamentous fungi of Mucorales from class Mucormycotina. After nasal inoculation, it usually spreads to orbit and brain. The common presenting complaints are purulent sinusitis, facial swelling, headache, complaints of vision or palatal ulceration. Despite the many recent advances in the diagnosis and management of mucormycosis, it still carries a high mortality rate.
 
 Materials and methods
 Here we present our experience in managing 30 such cases of mucormycosis that presented to our department between June 2016 to June 2018.
 
 Results
 All these patients were started on systemic antifungals with or without surgical debridement. The patients were followed up with repeated nasal endoscopies and imaging studies.
 
 Conclusion
 Successful treatment of mucormycosis consists of aggressive repeated surgical debridement of necrotic tissue, systemic antifungal therapy and immediate control of underlying systemic diseases. Since there are no clear-cut guidelines, the treatment needs to be individualized on a case to case basis.