Does affect combination of surgery with anti-fungal therapy prolong life a mucormycosis of sino-nasal? A Case Report

Abstract

Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive disease, which usually develops in patients with uncontrolled diabetes mellitus (DM) and those thatare immuno compromised.Mucor, Rhizopus, Absidia, Rhizomucor, and other mucorales fungi that belong to thedivision Zygomycota, or Aspergillus species that belong to the division Ascomycota, may be responsible for this disease. AIFRS exhibits high rates of mortality and morbidity, and prognosis of the disease mandates early diagnosis and treatment. Treatment includes immediate surgical intervention, systemic antifungal therapy, and quick treatment of the underlying systemic disease. Before the advent of amphotericin- B, mortality rates were as high as 90 percent. However, they have been reduced to 15 to 50 percent with the combined use of surgery and amphotericin-B. In this report, we present a case of mucormycosis of the rhino-orbital area treated with endoscopic sinus surgery, a medial maxillectomy with incomplete excision of the palate, and liposomal amphotericin B. The aim of this case report is to show that early surgery with medical therapy and regular follow-up could decrease mortality and increase life expectancy

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