Treatment of Rhino-orbital-cerebral Mucormycosis with Central Nervous System (Brain) Involvement

Clinical Scenario

This protocol covers rhino-orbital-cerebral mucormycosis in the specific setting where infection has extended to involve the central nervous system, including brain parenchyma — a severe disease extension that demands immediate, structured clinical action.

Treatment Approach

The approach centres on early and complete surgical intervention combined with prompt, high-intensity systemic antifungal therapy. Surgical debridement and antifungal treatment are initiated together; once a response is established, the regimen may be adjusted. The full protocol — including specific agents, sequence, and criteria for transitioning to oral therapy — is available via the link below.

Treatment Goals

The primary objective is stable disease or partial response of mucormycosis on response assessment, such as weekly imaging.

Instant Access to Structured Evidence-Based Regimens

References

  1. The guideline group strongly supports an early complete surgical treatment for mucormycosis whenever possible, in addition to systemic antifungal treatment.
  2. In CNS involvement, animal models and the above observations support use of liposomal amphotericin B at 10 mg/kg per day.
  3. There is moderate support for intravenous treatment until stable disease is achieved.
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