| Treatment of Rhino-Orbito-Cerebral Aspergillosis with Combination of Amphotericin, Posaconazole and Amphotericin Irrigation: A Case Report. |
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Sang Yeop Kim, Sang Jun Ko, Keum Ha Choi, Sang Duck Kim |
1Department of Ophthalmology, Wonkwang University School of Medicine, Iksan, Korea. sangduck@wonkwang.ac.kr
2Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea.
3Department of Pathology, Wonkwang University School of Medicine, Iksan, Korea. |
| 암포테리신, 포사코나졸 병용투여와 암포테리신 세척으로 치료한 비안와두부형 국균증 1예 |
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김상엽1,2⋅고상준1,2⋅최금하2,3⋅김상덕1,2 |
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원광대학교 의과대학 안과학교실1, 원광대학교 원광의과학연구소2, 원광대학교 의과대학 병리학교실3 |
Correspondence:
Sang Duck Kim,
Email: sangduck@wonkwang.ac.kr
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Received: 5 January 2017 • Revised: 17 April 2017 • Accepted: 19 May 2017 |
| Abstract |
PURPOSE
To report a case of rhino-orbito-cerebral aspergillosis successfully treated with a combination of amphotericin B, posaconazole and amphotericin B irrigation. CASE SUMMARY: A 59-year-old male with hypertension, diabetes mellitus and hyperlipidemia was admitted to our neurology department for left facial paresthesia, pain and consulted to ophthalmology for left eyeball pain. His visual acuity was no light perception in the left eye, and fundus examination showed papilledema and a cherry-red spot. Left exophthalmos and complete ptosis with ophthalmoplegia were also observed. Orbital computed tomography revealed left maxillary and ethmoid sinusitis, and nasal endoscopic examination revealed a black eschar adjacent to the middle turbinate. Subsequent biopsy suggested mucormycosis. The patient was immediately treated with a combination of amphotericin B and posaconazole. In addition, left endoscopic sinus surgery was performed and aspergillosis was histopathologically confirmed. The patient underwent amphotericin B irrigation for 5 days after canula insertion up to orbital apex. The patient survived for 18 months and is still alive. CONCLUSIONS: A combination of amphotericin B, posaconazole and amphotericin B irrigation using the canula through the orbital apex may be helpful in treating patients with rhino-orbito-cerebral aspergillosis who refuse orbital exenteration. |
| Key Words:
Amphotericin B;Amphotericin B irrigation;Posaconazole;Rhino-orbito-cerebral aspergillosis |
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