Hirabayashi Kristin E, Kalin-Hajdu Evan, Brodie Frank L, Kersten Robert C, Russell Matthew S, Vagefi M Reza
Departments of *Ophthalmology and †Otolaryngology - Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2017 Jul/Aug;33(4):e94-e97. doi: 10.1097/IOP.0000000000000806.
A 68-year-old immunocompromised man with rhino-orbital-cerebral mucormycosis was treated with retrobulbar injections of amphotericin B deoxycholate in conjunction with intravenous antifungals and endoscopic sinus debridement. Transient episodes of orbital inflammation were noted after retrobulbar injections, but progression of orbital infection was halted and visual acuity restored with eventual hospital discharge. To the authors' knowledge, clearance of orbital mucormycosis with retrobulbar amphotericin B injections has not been previously reported. This intervention may be a viable therapeutic option in cases of orbital mucormycosis where aggressive orbital debridement is not favored and/or the burden of orbital disease is not substantial. However, physicians should be aware of the risk of transient orbital inflammation secondary to retrobulbar amphotericin B deoxycholate.
一名68岁的免疫功能低下男性患有鼻眶脑毛霉菌病，接受了球后注射去氧胆酸两性霉素B治疗，同时联合静脉注射抗真菌药物和内镜鼻窦清创术。球后注射后出现了短暂的眼眶炎症，但眼眶感染的进展得到了控制，视力得以恢复，最终患者出院。据作者所知，此前尚未报道过通过球后注射两性霉素B清除眼眶毛霉菌病的情况。在不适合进行积极的眼眶清创术和/或眼眶疾病负担不严重的眼眶毛霉菌病病例中，这种干预措施可能是一种可行的治疗选择。然而，医生应意识到球后注射去氧胆酸两性霉素B继发短暂眼眶炎症的风险。
