Lujber L, Gerlinger I, Kuncz Á, Pytel J. Combination therapy for chronic invasive rhinocerebral aspergillosis in a clinically immunocompetent patient.
Curr Ther Res Clin Exp 2003;
64:473-83. [PMID:
24944397 PMCID:
PMC4053017 DOI:
10.1016/s0011-393x(03)00111-5]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/30/2003] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Adequate therapy for chronic invasive rhinocerebral aspergillosis in immunocompetent patients is controversial. The incidence of the disease is high in the Sudan and the Middle East. Misinterpretation of diagnostic criteria, failure to verify tissue invasion of fungi, and a lack of understanding of the pathophysiology of various forms of fungal rhinosinusitis lead to controversies in nomenclature, diagnosis, and therapy.
OBJECTIVE
The aim of this report was to detail the clinical presentation and the endoscopic and imaging study findings of a patient with invasive Aspergillus rhinosinusitis with endocranial and orbital extension. This patient was treated with surgical débridement and a combination of antifungal drugs and immunomodulatory therapy.
METHODS
Endoscopic débridement and high-dose liposomal amphotericin B, in combination with flucytosine and immunomodulators, were used to treat this patient.
RESULTS
After treatment, the patient experienced 3 years of disease-free follow-up.
CONCLUSION
Surgical débridement and high-dose systemic combined antifungal therapy with immunomodulatory drugs produced an excellent long-term result for this apparently immunocompetent patient with extensive invasive fungal rhinosinusitis with cerebral and orbital involvement.
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