The Role of Adjunctive Therapies in the Management of Invasive Sino-Orbital Infection.

Published

Journal Article (Review)

OBJECTIVE: Invasive sino-orbital fungal infections are life-threatening complications of immunonosupression that are difficult to treat. Currently there are no standard treatment guidelines. The most widely accepted therapy includes parenteral anti-fungal therapy and surgical debridement of sinuses with orbital exenteration, a procedure that is not only disfiguring, but may increase morbidity. Injection of retrobulbar Liposomal Amphotericin B (L-AMB) is an alternative approach that provides local administration to infected tissues. The adjunct use of anti-fungal retrobulbar injections not been extensively reviewed in treating sino-orbital infection. We are reporting the multimodal approach of using L-AMB retrobulbar injections in combination with sinus debridement, intravenous (IV) anti-fungal therapy, and hyperbaric oxygen (HBO) for the management of sino-orbital infection. METHOD & RESULTS: Review of literature of 12 cases and retrospective evaluation of one patient with sino-orbital Aspergillus flavus infection on chemotherapy for T-cell acute lymphocytic leukemia treated with retrobulbar Amphotericin B, IV anti-fungal agents, and hyperbaric oxygen therapy. Clinical characteristics, radiographic features, management techniques, and clinical outcomes are described. CONCLUSION: Retrobulbar Amphotericin B injection may be an effective adjunct to hyperbaric oxygen and parenteral anti-fungals in the control of sino-orbital fungal infections.

Full Text

Duke Authors

Cited Authors

  • Colon-Acevedo, B; Kumar, J; Richard, MJ; Woodward, JA

Published Date

  • September 2015

Published In

Volume / Issue

  • 31 / 5

Start / End Page

  • 401 - 405

PubMed ID

  • 26207927

Pubmed Central ID

  • 26207927

Electronic International Standard Serial Number (EISSN)

  • 1537-2677

Digital Object Identifier (DOI)

  • 10.1097/IOP.0000000000000488

Language

  • eng

Conference Location

  • United States