Use of Miconazole Cream As Adjunctive Therapy to Treat Isolated Sinus Mucormycosis: A Case Report and Literature Review

Black fungus, also known as mucormycosis, is one of the most serious infections affecting immunocompromised individuals. Invasive fungal sinusitis due to mucormycosis is quite rare globally. Hence, this article presents a case report of invasive fungal sinusitis in a 53-year-old diabetic female who presented to the emergency department with a severe case of diabetic ketoacidosis secondary to acute sinusitis, which was confirmed by histopathology to be mucormycosis. An extensive surgical debridement and liposomal amphotericin B were the mainstay of treatment. The treatment of mucormycosis consists of treating the underlying disease, antifungal therapy, and surgical debridement. Also, previous studies have discussed the use of medical therapy alone, surgical therapy alone, and combination therapy. It was found that the combination of medical and surgical therapy was the most effective method in treating this condition. However, the high mortality rate of this disease indicates the need for a possible adjuvant therapy which could increase the survival rate. Therefore, recent studies have proposed new adjuvant modalities, such as hyperbaric oxygen therapy and local treatment with amphotericin B. In this study, we propose a new adjuvant therapy using local miconazole cream which showed a good prognosis with the combination of oral amphotericin B and surgical debridement. This highlights the necessity for extensive future clinical trials to validate its effectiveness in treating isolated sinus mucormycosis.