Periorbital cellulitis secondary to Conidiobolus incongruus

A previously healthy, 18-month-old girl developed edema and erythema around her left eye 1 week after getting sand in that eye. The patient did not re spond to oral or intravenous antibiotics. A mass developed around the eye, and biopsy revealed Conidiobolus incongruus. The patient failed to respond to amphotericin B 1 mg/kg, and susceptibility tests indicated multiantifung al resistance. A combination of antifungal therapy, hyperbaric oxygen, and surgery was required for successful treatment. Three months after treatment the child was disease free. There is no definitive therapy for Conidiobolu s incongruus infections, although various drugs have been administered with some success. When susceptibility tests determine multidrug resistance, ra dical resection with antifungal chemotherapy and hyperbaric oxygen may be n ecessary as well as lifesaving.