Long-term survival of a patient with invasive cranial base rhinocerebral mucormycosis treated with combined endovascular, surgical, and medical therapies

Case report

Cargill Herley Alleyne, A. Giancarlo Vishteh, Robert F. Spetzler, Paul W. Detwiler

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE: Rhinocerebral mucormycosis is a clinical syndrome resulting from an opportunistic infection caused by a fungus of the order Mucorales. 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 PRESENTATION: A 24-year-old diabetic man presented with invasive rhinocerebral mucormycosis involving the paranasal sinuses, right middle fossa, and right cavernous sinus. INTERVENTION: The 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. CONCLUSION: Long-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.

Original languageEnglish (US)
Pages (from-to)1461-1464
Number of pages4
JournalNeurosurgery
Volume45
Issue number6
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Fingerprint

Mucormycosis
Skull Base
Survival
Cavernous Sinus
Paranasal Sinuses
Mucorales
Therapeutics
Opportunistic Infections
Carotid Arteries
Intravenous Administration
Early Diagnosis
Fungi
Pathology
Anti-Bacterial Agents
Muscles
Mortality

Keywords

  • Carotid sacrifice
  • Fungal infection
  • Rhinocerebral mucormycosis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Long-term survival of a patient with invasive cranial base rhinocerebral mucormycosis treated with combined endovascular, surgical, and medical therapies : Case report. / Alleyne, Cargill Herley; Vishteh, A. Giancarlo; Spetzler, Robert F.; Detwiler, Paul W.

In: Neurosurgery, Vol. 45, No. 6, 01.01.1999, p. 1461-1464.

Research output: Contribution to journalArticle

Alleyne, Cargill Herley ; Vishteh, A. Giancarlo ; Spetzler, Robert F. ; Detwiler, Paul W. / Long-term survival of a patient with invasive cranial base rhinocerebral mucormycosis treated with combined endovascular, surgical, and medical therapies : Case report. In: Neurosurgery. 1999 ; Vol. 45, No. 6. pp. 1461-1464.
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