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DOI: 10.1055/a-2558-6468
Preoperative Administration of Amphotericin B in Orbital Mucormycosis Management: A Case Report
Abstract
This case report presents a 29-year-old male with diabetes mellitus who developed rhino-orbito-cerebral mucormycosis (ROCM) that was successfully treated with liposomal amphotericin B orbital injections. Despite emergent endoscopic debridement, the patient's disease progressed intracranially and intraorbitally, but he declined further surgical intervention. Subsequently, due to rapid acute vision loss, we initiated transcutaneous retrobulbar amphotericin B (TRAMB) injections. Following these injections, visual acuity, motility, and intraorbital fungal burden improved despite intracranial progression. This report highlights the benefits of TRAMB administration in aggressive fungal infections and explores the mechanisms behind its effectiveness, particularly in globe preservation. By targeting the infection in an area with a relatively robust blood supply, TRAMB reduces surgical difficulty and improves overall outcomes.
Keywords
orbital mucormycosis - amphotericin B - globe preservation - fungal infection - diabetes mellitus - preoperative management - intracranial extension - TRAMB injections - antifungal therapy - minimally invasive treatmentPublication History
Received: 18 November 2024
Accepted: 08 March 2025
Accepted Manuscript online:
17 March 2025
Article published online:
11 April 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
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