RESUMO
Paranasal sinus mucormycosis is a rare and often fatal condition that occasionally occurs in patients with debilitating disease. Five mucormycosis cases with paranasal sinus involvement are reported. Two also complicated diabetes mellitus. These diabetic patients rapidly developed meningitis after the onset of symptoms. One case was soon operated upon and necrotic masses with fungus were excised. Despite i.v. amphotericin B administration, two patients lost their consciousness in a few days, relapsed into coma and died. In these cases, the infection originated from the ethmoidal sinus and directly spread towards the orbit and brain. The remaining three cases with mucormycosis had operations after the initial diagnosis of sinusitis. All of the three patients are alive and well. The combination of an excisional operation and antifungal therapy resulted in favorable response. High resolution CT scanning is valuable both in planning treatment and monitoring the response to therapy.
Assuntos
Mucormicose , Doenças dos Seios Paranasais , Adulto , Idoso , Terapia Combinada , Complicações do Diabetes , Diabetes Mellitus/imunologia , Feminino , Humanos , Tolerância Imunológica , Masculino , Pessoa de Meia-Idade , Mucormicose/diagnóstico por imagem , Mucormicose/patologia , Mucormicose/terapia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/terapia , Tomografia Computadorizada por Raios XRESUMO
Five cases of mucormycosis are reported, 2 of them suffered from immunosuppression, the other 3 did not. We conclude that a combination of CT and bacteriological findings is useful for the diagnosis of mucormycosis differentially from other diseases. Therapy consisted of paranasal debridement and administration of amphotericin B.