שאלה משלב א׳ במחלות עיניים · מועד 2024 (Sep), שאלה 19

The finding that supports medical rather than exenterative treatment is intracranial extension on MRI: once rhino-orbital-cerebral mucormycosis has reached the brain, exenteration can no longer achieve local control, so the approach becomes systemic antifungal therapy (liposomal amphotericin B, then posaconazole or isavuconazole) with sinus debridement and correction of the underlying diabetes and ketoacidosis. Retinal ischaemia, necrotic turbinate mucosa and broad non-septate branching hyphae all CONFIRM the diagnosis and would, in the absence of intracranial spread, argue for radical surgery.

מקור: Kanski p. 7 54