Rhino-orbital-cerebral mucormycosis (ROCM) is a rare and often fatal infection usually occurring in immunocompromised patients from diseases such as diabetes, haematological malignancy and solid organ transplantation. Current standards of care include systemic antifungal therapy and debridement, including exenteration. This study is a retrospective comparison between patients that have and have not received off-label retrobulbar injection of amphotericin B. Primary outcome measures included rate of orbital exenteration and disease-specific mortality. The authors found that, in local orbital involvement, there was a lower rate of exenteration in patients who received retrobulbar injection of amphotericin B compared to those that did not. In extensive disease there was no significant difference in rate of exenteration and in fact there was worsening of orbital congestion in the retrobulbar injection group. Although the study shows some benefit in a specific proportion of patients with mucormycosis, it is a complicated condition to treat and the best management regime is yet to be established.
Retrobulbar amphotericin B for rhino-orbital-cerebral mucormycosis
Reviewed by Hetvi Bhatt
Transcutaneous retrobulbar amphotericin B for rhino-orbital-cerebral mucormycosis: a multi-centre retrospective comparative study.
CONTRIBUTOR
Hetvi Bhatt
Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
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