Management of Rhino-Orbital-Cerebral Mucormycosis Infection: Anesthetic Challenges

Despite the application of surgery and antifungal therapy, rhino-orbital-cerebral mucormycosis is a severe and life-threatening fungal infection with high morbidity and mortality, particularly in immunocompromised patients. This review focuses on the current evidence on the perioperative anesthetic management of rhino-orbital-cerebral mucormycosis, emphasizing the unique challenges its aggressive, angioinvasive nature poses. Key issues include difficult airway management due to fungal debris and supraglottic edema, hemodynamic instability, renal dysfunction because of nephrotoxic antifungal therapy (e.g., amphotericin B), and the critical need for glycemic control in diabetic patients. Case studies illustrate the complexities of managing comorbidities such as post-COVID-۱۹ sequelae, uncontrolled diabetes, and immunosuppression. Preoperative optimization, judicious fluid and electrolyte management, and the use of video laryngoscopy for difficult intubation are highly recommended. By addressing these challenges, this article provides a practical framework for anesthesiologists to enhance perioperative care in patients with ROCM, ultimately improving survival and reducing complications. Awareness of these procedures may help clinicians choose the most effective treatment regimens. However, further studies are warranted to correlate these findings with clinical outcomes.

کلیدواژه ها:

Mucormycosis ، Rhino-Orbital-Cerebral ، Immunocompromised hosts ، Anesthetic management