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Long-term Survival of a Patient with Invasive Cranial Base Rhinocerebral Mucormycosis Treated with Combined Endovascular, Surgical, and Medical Therapies: Case Report

 

作者: Cargill Alleyne,   A. Vishteh,   Robert Spetzler,   Paul Detwiler,  

 

期刊: Neurosurgery  (OVID Available online 1999)
卷期: Volume 45, issue 6  

页码: 1461-1461

 

ISSN:0148-396X

 

年代: 1999

 

出版商: OVID

 

关键词: Carotid sacrifice;Fungal infection;Rhinocerebral mucormycosis

 

数据来源: OVID

 

摘要:

OBJECTIVERhinocerebral mucormycosis is a clinical syndrome resulting from an opportunistic infection caused by a fungus of the orderMucorales. The prognosis of rhinocerebral mucormycosis, once considered uniformly fatal, remains poor. Even with early diagnosis and aggressive surgical and medical therapy, the mortality rate is high. We present a patient with rhinocerebral mucormycosis involving the paranasal sinuses and cranial base who experienced long-term survival after multimodality treatment. Clinical characteristics of the disease are discussed, and the literature is reviewed.CLINICAL PRESENTATIONA 24-year-old diabetic man presented with invasive rhinocerebral mucormycosis involving the paranasal sinuses, right middle fossa, and right cavernous sinus.INTERVENTIONThe patient underwent endovascular sacrifice of the involved carotid artery and radical resection of the cranial base, including exenteration of the cavernous sinus. Reconstruction with a local muscle flap was performed. He continued to receive intravenous and intrathecal administration of antibiotics.CONCLUSIONLong-term survival with invasive rhinocerebral mucormycosis is rare, but possible, with aggressive multimodality treatment, including carotid sacrifice for en bloc resection of the pathology, when indicated.

 



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