Successful Right Orbital Exenteration for Mucormycosis in a Young Woman

Abstract

Journal of Case Reports in Medicine,2012,1,1,1-2.Published:Jun 2012Type:Case ReportAuthors:Pallavi Ojha, Vincent Lam, Yelena Doych, Myron Yanoff, and Amiram Shapiro Author(s) affiliations:Pallavi Ojha, Vincent Lam, Yelena Doych, Myron Yanoff, and Amiram Shapiro Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, PA 19102, USA. Abstract:Purpose. We report successful treatment of a 32-year-old woman with a history of acute lymphoblastic leukemia who presented with rhino-orbital mucormycosis and successfully underwent right orbital exenteration and treatment of her mucormycosis. Mucormycosis is a severe fungal infection that is often fatal in immunosuppressed patients. The mainstay of therapy is intravenous amphotericin B and surgical debridement of affected tissue. Methods. Treatment included intravenous antifungal agents, debridements with local drug delivery, hyperbaric oxygen, deferasirox, and right orbital exenteration. Results. Integration of numerous therapeutic modalities led to a successful outcome. The patient is alive and well more than 3 years later. Conclusions. Surgical excision is traditionally considered the only treatment for mucormycosis. This case is a reminder of the adjunctive forms of treatment. Keywords:Fungal eye infections; Mucormycosis; Orbital exenterationView:PDF (939.56 KB) PDF Images Figure 1: Magnetic resonance imaging of the brain showed proptosis, inflammation extending to the orbital apex effacing the right optic nerve, and opacification of the right ethmoid and sphenoid air cells.