Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Ryan Beaver; Brianna Garza; Hasanthi Vallabhaneni; Lizbeth Cahuayme-Zuniga; John Midturi; Tiffany LaDow

doi:10.1016/j.mmcr.2021.06.003

Use of topical amphotericin in a case of refractory sino-orbital angioinvasive mucormycosis

Med Mycol Case Rep. 2021 Jul 5:33:21-25. doi: 10.1016/j.mmcr.2021.06.003. eCollection 2021 Sep.

Authors

Ryan Beaver¹, Brianna Garza², Hasanthi Vallabhaneni³, Lizbeth Cahuayme-Zuniga¹, John Midturi¹, Tiffany LaDow³

Affiliations

¹ Division of Infectious Diseases, Baylor Scott & White Medical Center Temple, Temple, TX, USA.
² The Texas A&M University Health Science Center Rangel College of Pharmacy, Temple, TX, USA.
³ Department of Pharmacy, Baylor Scott & White Medical Center Temple, Temple, TX, USA.

Abstract

The standard of care for treatment of sino-orbital mucormycosis involves aggressive surgical debridement and liposomal amphotericin, and the roles of adjunctive and topical therapies are less clear. Here we describe a case of severe refractory sino-orbital mucormycosis in an immunocompetent patient who responded to combination therapy with liposomal amphotericin, isavuconazole, micafungin, and topical amphotericin deoxycholate after failing to achieve negative surgical margins.

Keywords: Mucormycosis; Orbital exenteration; Rhizomucor; Topical amphotericin.

Publication types

Case Reports