INTRACONAL AMPHOTERICIN-B FOR THE TREATMENT OF RHINO-ORBITAL MUCORMYCOSIS

Rhino-orbital-cerebral mucormycosis is a disease that is frequently fa tal. A 39-year-old man with diabetic ketoacidosis was referred to the authors' ophthalmic service with fever, orbital apex syndrome in the r ight eye, lethargy, and a black eschar in the palate. He was treated w ith systemic and local (intraconal) amphotericin B and his ketoacidosi s was controlled; exenteration was not performed. Biopsy of the palate proved mucormycosis. Eighteen months later the patient was still aliv e and had a blind, anatomically preserved right eye with ptosis and in tact extraocular muscle function without proptosis or pain. The author s propose this alternative means of treatment to achieve higher doses of the drug at the site of infection and better cosmetic and psycholog ical results.