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Chronic Phycomycosis of the Upper Respiratory Tract
Rhinophycomycosis Entomophthorae
Rhinophycomycosis entomophthorae, a chronic infection of the upper respiratory tract caused by a phycomycete, Entomophthora coronata, is a relatively new disease compared with infections by other fungi of the same class, but different genera, that involve other parts of the body as well. Sixteen cases have been seen, studied, and followed since the disease was first recognized in this unit and reported under the name rhinophycomycosis. Observations suggest that the disease, unlike some other mycotic infections, does not regress spontaneously and that it is not opportunistic. The mode of action of potassium iodide in the treatment of these cases is uncertain, but the drug has proved efficacious from the outset in all but two cases; in these resistance to the drug is thought to have developed through interruption of treatment. Other forms of treatment have been tried, and one of these (sulphamethoxazole with trimethoprim) proved successful in both resistant cases almost simultaneously. Experience suggests that the addition of a sulphonamide is helpful, if not essential, and that surgery should be restricted to biopsies only.