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October 28, 1996

Rhinocerebral Mucormycosis: Cure Without Surgery?-Reply

Author Affiliations

Tucson, Ariz

Arch Intern Med. 1996;156(19):2269. doi:10.1001/archinte.1996.00440180126018

My colleagues and I thank Anand et al for pointing out the case of a patient with isolated cerebral mucormycosis who was cured by medical therapy. In fact, Gollard et al1 cited 2 additional patients with isolated cerebral mucormycosis who were cured with medical therapy alone. Although our own review was limited to patients with rhinocerebral mucormycosis, these medical cures of isolated cerebral mycormycosis are also quite remarkable and are worthy of note.

Regarding the treatment of mucormycosis, it is important to keep several factors in mind: (1) The best results are obtained when surgical therapy is combined with high doses of amphotericin B. Whether the higher dose of amphotericin B that can be administered as the lipid complex formulation will result in greater clinical efficacy remains to be determined. Medical therapy alone should be reserved for patients in whom surgical resection is not a reasonable option. (2) When

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