Rhino-orbital mucormycosis in a patient with acquired immunodeficiency syndrome (AIDS) and neutropenia

• Published in: American journal of ophthalmology Vol. 132; no. 1; pp. 111 - 112
• Main Authors: Hejny, Charles, Kerrison, John B, Newman, Nancy J, Stone, Cameron M
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2001; Elsevier
• Subjects: Acquired Immunodeficiency Syndrome - complications; Amphotericin B - administration & dosage; Antifungal Agents - administration & dosage; Biological and medical sciences; Debridement; Eye Infections, Fungal - diagnosis; Eye Infections, Fungal - etiology; Eye Infections, Fungal - therapy; Human viral diseases; Humans; Infectious diseases; Leukocyte Count; Liposomes; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Mucormycosis - diagnosis; Mucormycosis - etiology; Mucormycosis - therapy; Neutropenia - complications; Orbital Diseases - diagnosis; Orbital Diseases - etiology; Orbital Diseases - therapy; Paranasal Sinus Diseases - diagnosis; Paranasal Sinus Diseases - etiology; Paranasal Sinus Diseases - therapy; Risk Factors; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Visual Acuity; Human; Immunopathology; Leukopenia; Mycosis; Orbit(eye) disease; AIDS; Hemopathy; Orbit(eye); Immune deficiency; Infection; Case study; Mucormycosis; Viral disease; Nose; ENT disease; Complication; Neutropenia
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(00)00933-8

PURPOSE: To present a case of rhino-orbital mucormycosis in a patient with AIDS and neutropenia managed without exenteration. METHODS: Case report. RESULTS: A 60-year-old African-American man with AIDS developed neutropenia that was probably secondary to antiretroviral therapy. He developed right rhino-orbital mucormycosis and was treated with right partial ethmoidectomy with debridement and liposomal amphotericin B. The infection was cured without need for orbital exenteration, although visual acuity in his right eye ultimately was no light perception. CONCLUSION: Rhino-orbital mucormycosis is uncommon in patients with AIDS. When rhino-orbital mucormycosis occurs, patients require a careful search for an underlying metabolic derangement such as neutropenia. Treatment should be aggressive, but these patients may not require orbital exenteration.