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Indolent mucormycosis of the paranasal sinus in immunocompetent patients: are antifungal drugs needed?

Published online by Cambridge University Press:  13 August 2013

H Jung  and
S K Park
H Jung
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Inje University School of Medicine, Busan Paik Hospital, Busan, South Korea
S K Park*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Inje University School of Medicine, Busan Paik Hospital, Busan, South Korea
*
Address for correspondence: Dr Seong Kook Park, Department of Otorhinolaryngology-Head and Neck Surgery, Inje University, School of Medicine, Busan Paik Hospital, 633-165 Keakeum-dong, Busanjin-Ku, Busan 614-735, South Korea Fax: +82 51 892 3831 E-mail: sinus4@paik.ac.kr
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Abstract

Objective:

To report the clinical characteristics and treatment outcomes of indolent paranasal mucormycosis in immunocompetent individuals.

Materials and methods:

A retrospective review of four immunocompetent patients with indolent mucormycosis of the paranasal sinus managed by endoscopic sinus surgery only was performed. One year of regular follow up comprised angled endoscopy and repeated paranasal sinus computed tomography three months after surgery.

Results:

Clinical symptoms were non-specific. Pre-operative paranasal sinus computed tomography showed opacification of the unilateral maxillary sinus with focal calcification but without bony destruction or extension to the orbit or cranium. All patients underwent endoscopic sinus surgery without administration of antifungal agents. There was no recurrence on regular clinical and radiological follow up.

Conclusion:

For indolent paranasal mucormycosis in immunocompetent patients, endoscopic sinus surgery can be the treatment of choice, and the administration of antifungal drugs may not be necessary.

Keywords

MucormycosisParanasal SinusesAmphotericin BSurgical Procedures, OperativeImmunocompetence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 872 - 875
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1deShazo, RD, O'Brien, M, Chapin, K, Soto-Aguilar, M, Gardner, L, Swain, R. Anew classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 1997;123:1181–8CrossRefGoogle ScholarPubMed
2Shoham, S, Levitz, SM. The immune response to fungal infections. Br J Haematol 2005;129:569–82CrossRefGoogle ScholarPubMed
3Rogers, TR. Treatment of zygomycosis: current and new options. J Antimicrob Chemother 2008;61(suppl 1):i35–9CrossRefGoogle ScholarPubMed
4Ruoppi, P, Dietz, A, Nikanne, E, Seppa, J, Markkanen, H, Nuutinen, J. Paranasal sinus mucormycosis: a report of two cases. Acta Otolaryngol 2001;121:948–52CrossRefGoogle ScholarPubMed
5Del Valle Zapico, A, Rubio Suarez, A, Mellado Encinas, P, Morales Angulo, C, Cabrera Pozuelo, E. Mucormycosis of the sphenoid sinus in an otherwise healthy patient. Case report and literature review. J Laryngol Otol 1996;110:471–3CrossRefGoogle Scholar
6Prabhu, RM, Patel, R. Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment. Clin Microbiol Infect 2004;10(suppl1):31–47CrossRefGoogle ScholarPubMed
7Artis, WM, Fountain, JA, Delchere, HK, Jones, HE. A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. Diabetes 1982;31:1109–14CrossRefGoogle ScholarPubMed
8Pastore, PN. Mucormycosis of the maxillary sinus and diabetes mellitus: report of a case with recovery. South Med J 1967;60:1164–7CrossRefGoogle ScholarPubMed
9Henderson, LT, Robbins, KT, Weitzner, S, Dyer, TC, Jahrsdoerfer, RA. Benign mucor colonization (fungus ball) associated with chronic sinusitis. South Med J 1988;81:846–50CrossRefGoogle ScholarPubMed
10Yohia, RA, Bullock, JD, Aziz, AA, Markert, RJ. Survival factors in rhino-orbital-cerebral mucormycosis. Surv Ophthalmol 1994;39:3–22CrossRefGoogle Scholar
11Ketenci, I, Unlu, Y, Senturk, M, Tuncer, E. Indolent mucormycosis of the sphenoid sinus. Otolaryngol Head Neck Surg 2005;132:341–2CrossRefGoogle ScholarPubMed
12Ferguson, BJ. Mucormycosis of the nose and paranasal sinuses. Otolaryngol Clin North Am 2000;33:349–65CrossRefGoogle ScholarPubMed
13Avet, PP, Kline, LB, Sillers, MJ. Endoscopic sinus surgery in the management of mucormycosis. J Neuroophthalmol 1999;19:56–61CrossRefGoogle ScholarPubMed
14Uri, N, Cohen-Kerem, R, Elmalah, I, Doweck, I, Greenberg, E. Classification of fungal sinusitis in immunocompetent patients. Otolaryngol Head Neck Surg 2003;129:372–8CrossRefGoogle ScholarPubMed
15Blitzer, A, Lawson, W, Meyeres, BR, Biller, HF. Patient survival factors in paranasal sinus mucormycosis. Laryngoscope 1980;90:635–48CrossRefGoogle ScholarPubMed