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Vol. 61. Issue 1.
Pages 48-53 (January 2010)
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Vol. 61. Issue 1.
Pages 48-53 (January 2010)
Brief report
Rhino-orbito-cerebral mucormycosis, a retrospective study of 7 cases
Mucormicosis rinoorbitocerebral, un estudio retrospectivo de 7 casos
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Pablo Santos Gorjón
Corresponding author
pabmaransantos@hotmail.com

Corresponding author.
, Pedro Blanco Pérez, Ángel Batuecas Caletrío, Ángel M. Muñoz Herrera, Fernando Sánchez González, Rebeca de la Fuente Cañibano
Servicio de Otorrinolaringología y Patología Cervico-Facial, Hospital Universitario de Salamanca, Salamanca, Spain
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Abstract

Mucormycosis is an opportunistic fungal infection caused by fungi of the Mucorales order. It has a low incidence and is a potentially lethal infection that generally affects patients who are immunocompromised due to systemic disease. We report 7 cases of rhinocerebral mucormycosis in an 8-year retrospective study (2000–2008) in haematological patients. Early diagnosis is essential, and there must therefore be a high level of clinical suspicion in patients with predisposing factors. Certain diagnosis requires fungal cultures or biopsies of the affected areas that prove an invasion of the tissues by the characteristic hyphae. The key to treatment is early and aggressive surgical treatment, together with high intravenous doses of amphotericin B. Despite this, prognosis is poor and mortality is about 70%–80%.

Keywords:
Immunocompromised
Diabetes mellitus
Fungal sinusitis
Rhinocerebral mucormycosis
Zygomycetes
Rhizopus oryzae
Resumen

La mucormicosis es una infección oportunista, producida por los hongos del orden mucorales. Tiene una baja incidencia. Es potencialmente letal y afecta a pacientes inmunocomprometidos. Presentamos 7 casos de mucormicosis rinocerebral en un estudio retrospectivo de 8 años (2000–2008) en pacientes hematológicos. Es preciso realizar un diagnóstico precoz, para lo cual se ha de mantener un alto índice de sospecha clínica en pacientes con factores predisponentes. El diagnóstico de certeza requiere la realización de cultivos o biopsias de las zonas afectadas que demuestren la invasión de los tejidos por las hifas características. La clave del tratamiento es el desbridamiento quirúrgico precoz y agresivo, junto con altas dosis de amfotericina B intravenosa. A pesar de este tratamiento, el pronóstico es desfavorable y la mortalidad es de un 70–80%.

Palabras clave:
Inmunodeprimidos
Diabetes mellitus
Sinusitis fúngica
Mucormicosis rinocerebral
Zigomicetos
Rhizopus oryzae

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