A 50-year-old uncontrolled diabetic develops acute invasive fungal sinusitis confirmed on biopsy showing broad aseptate hyphae invading blood vessels. Along with emergency debridement and glycemic control, which drug is the mainstay of medical therapy?
- A Liposomal amphotericin B ✓
- B Voriconazole
- C Fluconazole
- D Casposfungin as monotherapy
Correct answer: A. Liposomal amphotericin B
Explanation
Rhinocerebral mucormycosis is treated with three pillars: correction of the underlying risk factor, aggressive surgical debridement of all necrotic tissue, and liposomal amphotericin A, which remains first-line therapy. Voriconazole is active against Aspergillus but not against Mucorales, making it the classic distractor. Fluconazole lacks activity against Mucorales, and echinocandins are used only as salvage or combination agents, never as monotherapy.
Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.