| Abstrakt: |
Introduction: Mucormycosis of the nose and paranasal sinuse is a rare, invasive fungal infection that mainly affects immunocompromised patients with higher morbidity and mortality. Objective: To report a non-fatal case of a patient with type 2 diabetes diagnosed with infiltrative mucormycosis of the nose and paranasal sinuse. Case report: A.P.L, 54 years, male, rural producer, uncontrolled type 2 dyabetes, hospitalized on 02/24/2022 due to left facial pain, ipsilateral edema and a painless lesion in the left hard palate, after tooth extraction surgery despite the use of Amoxicillin with Clavulanate and Levofloxacin. Tracheostomy followed by left maxillectomy and surgical debridement in left necrotic tissue was performed in urgency. Histopathological analysis suggestive of infiltrative mucormycosis, and culture of fungi with growth of Rhizoppus sp. During the hospitalization, glycemic control was achieved and polymyxin B, Meropenem and Amphotericin B lipid complex was used. However, he evolved with kidney dysfunction, elevation of canalicular enzymes, sepsis and an episode of acute myocardial infarction. After two months, CT paranasal sinus and brain resonances was performed with evidence of undefined lesion in right maxillary sinus and left orbit, followed by right maxillary antrostomy, Caldwell-Luc on the right and debridement of the left orbital floor with removal of fungus suggestive material. After prolonged hospitalization for 3 months, he was discharged with clinical improvement in use of oral isavuconazole Conclusion: Treatment of nasosinusal mucormycosis is complex. It involves a multidisciplinary team, and surgical treatment is essential for complete improvement. [ABSTRACT FROM AUTHOR] |
