Rhinocerebral mucormycosis: premortem diagnosis and therapy

Abstract

The diagnosis of rhinocerebral mucormycosis is most often made at autopsy. The diagnosis was established premortem in 9 patients. Of the patients, 6 had underlying diabetes mellitus and 3 had acute leukemia. Facial or ocular pain was the complaint found in all patients and frequently was the initial symptom. The diagnosis was established by examination and culture of infected tissue obtained by biopsy. In 7 patients, identification of hyphal elements in smears of biospy material allowed the immediate institution of amphotericin B therapy. Of the 7 patients treated with amphotericin B, 4 survived. All surviving patients had underlying diabetes mellitus and underwent surgical debridement. Early diagnosis leading to immediate institution of appropriate therapy is most important for survival of patients with mucormycosis.