Survival in cerebro-rhino-orbital zygomycosis and cavernous sinus thrombosis with combined therapy

South Med J. 1986 Apr;79(4):501-4. doi: 10.1097/00007611-198604000-00028.


An alcoholic man with uncontrolled diabetes mellitus had right conjunctivitis, facial numbness, and periorbital edema progressing to bilateral visual loss, and left ptosis in association with a large necrotic palatal ulcer due to zygomycosis. The infection progressed to bilateral retinal vein engorgement; left-sided ophthalmoplegia, fixed dilated pupil, and absent corneal reflex; and right-sided ophthalmoplegia, ptosis, and facial nerve paralysis. Work-up revealed disease of both ethmoid sinuses and the right maxillary sinus, with bilateral thromboses of the cavernous sinuses. An aggressive combined therapeutic attack (three Caldwell-Luc procedures, exploration of orbit walls, control of diabetes, systemic and local amphotericin therapy) led to survival with a three-year follow-up thus far.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Brain Diseases / diagnosis*
  • Brain Diseases / therapy
  • Cavernous Sinus*
  • Combined Modality Therapy
  • Debridement
  • Diabetes Mellitus, Type 1 / complications
  • Fungi / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Mucormycosis / diagnosis*
  • Mucormycosis / therapy
  • Nose Diseases / diagnosis*
  • Nose Diseases / therapy
  • Orbital Diseases / diagnosis*
  • Orbital Diseases / therapy
  • Sinus Thrombosis, Intracranial / diagnosis*


  • Amphotericin B