gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Invasive mucormycosis of the sinuses: costs and outcome

Meeting Abstract

  • corresponding author Kathrin Scheckenbach - Universität Düsseldorf, Düsseldorf
  • Martin Wagenmann - Universität Düsseldorf, Düsseldorf
  • Oliver Cornely - Universität Köln, Kön
  • Thomas Hoffmann - Universität Düsseldorf, Düsseldorf
  • Henning Bier - Universität Düsseldorf, Düsseldorf

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno669

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2005/05hno206.shtml

Veröffentlicht: 22. September 2005

© 2005 Scheckenbach et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Rhinocerebral Mucormycosis is an agressive, fungal infection of the sinuses, which leads to inflammatory invasion and destruction of the surrunding tissue and ends up with death in 80% of the cases. The illness progresses rapidely, sometimes fulminant, mainly in diabetic and immonosuppressed persons. An early diagnosis and treatment is very important for the outcome. It comprises radical surgery, management of the predisposing illness and systemic antifungal therapy. As standard medication Amphotericin is given in a water-soluble or lipid-associated form. The new antimycotic drug Posaconazol is an upcoming new alternative to Amphotericin.

During the last 2 years we treated 4 patients suffering from a mucormycosis. As predisposing illness two of them showed a poorly controlled diabetes mellitus, one suffered from CLL and one of a myelodysplastic syndrome. In every case radical surgery and a systemic antifungal therapy were performed, which led to costs of up to 26.000€ in one case only during the time in the clinic. Despite intensive therapy, 3 patients died within a time from 2 weeks to 3 month. Only one patient, who showed no cerebral invasion and received exclusively Posaconazol survived for about one year now. Although there is no possibility to predict the individual outcome, and despite high costs, treatment of patient suffering from mucormycosis should be started with maxiaml therapy. New promising drugs like Posaconazol are upcoming.