Mucormycosis-induced brain abscess treatment without dura opening- a report of three cases

Abstract

Abstract purpose Brain abscess following sinonasal mucormycosis is a rare but life-threatening condition that usually occurs during the patient's treatment. Therefore, it is important to pay close attention to its identification and treatment and since our knowledge is mostly based on case reports, a well-documented way of treatment for such cases is yet to be found. Methods A retrospective case series study was conducted at a tertiary hospital. Initially, all patients with brain abscesses following sino-nasal mucormycosis were included, and then patients whose brain abscesses were treated without opening the dura during surgery were selected for the study. The patients received radical debridement of necrotic tissues as well as the infected bones adjacent to the brain abscess cavity. But the dura was not incised. Then they were treated medically for their underlying disease and also with Amphotericine-B. Their brain abscess was monitored 3 weeks post-operatively. Results Three patients with an average age of 41 years were included in the study. All patients had a history of diabetes and had previously been treated for COVID-19 before developing symptoms of sino-nasal infection. The average size of the abscesses was less than 2 cm. Two patients had abscesses in the temporal lobe and one in the frontal lobe. Conclusion Treating brain abscesses adjacent to the skull base by removing infected tissues and bones surrounding the brain abscess without opening the dura can be a viable treatment option for mucormycosis-induced brain abscesses of less than 2 cm. Ethics approval statement: IR.TUMS.AMIRALAM.REC.1402.036