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LETTER TO EDITOR
Year : 2004  |  Volume : 52  |  Issue : 1  |  Page : 82

Rhino-orbital-cerebral mucormycosis. A retrospective analysis and treatment option



Correspondence Address:
S M Betharia


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Source of Support: None, Conflict of Interest: None


PMID: 15132392

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How to cite this article:
Betharia S M, Wagh VB, Pathak H, Sharma V. Rhino-orbital-cerebral mucormycosis. A retrospective analysis and treatment option. Indian J Ophthalmol 2004;52:82

How to cite this URL:
Betharia S M, Wagh VB, Pathak H, Sharma V. Rhino-orbital-cerebral mucormycosis. A retrospective analysis and treatment option. Indian J Ophthalmol [serial online] 2004 [cited 2019 Oct 16];52:82. Available from: http://www.ijo.in/text.asp?2004/52/1/82/14619

Dear Editor,

We read with great interest the article "Rhino-orbito-cerebral mucormycosis. A retrospective analysis and treatment options".[1] We congratulate the authors for this very informative article on this rare and important topic. The authors have defined the management and prognosis of mucormycosis. However, we would request a clarification. They have stated that there was no difference in ophthalmoplegia and central retinal artery occlusion in clinical stage II between Treatment group A (TG - A) and Treatment group B (TG - B), which is contradictory to the data given in. In TG-A four patients received local amphotericine B and four patients received oral ketaconazole. It would be interesting to discuss the comparsion in speed of response, outcome and side effects with other patients in the same group as the efficacy of these modalities is yet to be fully established. Advantages of local amphotericine B reported in literature are lower risk, and its aid in delivery of AMP-B to poorly perfused and infected tissues, while consistent efficacy of ketaconazole against Mucoracae has not been found. [2] Hyperbaric oxygen therapy should have been considered in the management as this has been shown to be valuable due to its fungi- static effect.[2] It was also mentioned that in seven patients CT scan could not demonstrate soft tissue lesion despite clinical evidence of involvement. It would have been better if an MRI could have been done in these patients as the MRI is considered to be superior in demonstrating characteristic findings of hypo intensity of mycetoma on T-2 weighted MR images, better soft tissue delineation and multiplanar images. [2],[3]



 
  References Top

1.
Nithyanandam S, Jacob MS, Battu RR, Thomas RK, Correa MA, D'Souza O. Rhino cerebral mucormycosis. A retrospective analysis and treatment options. Indian J Ophthalmol 2003;51:231-36.  Back to cited text no. 1
[PUBMED]    
2.
Yohai RA, Bullock JD, Aziz AA, Markert RJ. Survival factors in Rhino-orbital-cerebral mucormycosis. Surv Ophthalmol 1994; 39:3-22  Back to cited text no. 2
[PUBMED]    
3.
Som Pm, Curtin HD. Orbit embryology, anatomy and pathology. In: Mahmood F Mafee, editors. Head and neck imaging . St.Louis, Mosby. 2003. Vol. 1, pp 5629-55.  Back to cited text no. 3
    



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