A patient having a fungal infection of sinuses and periorbital region with significant visual impairment, the patient has a history of diabetes also. The best drug among the following is
High-Yield Explanation
Amphotericin B is either fungicidal or fungistatic, depending on the organism and the concentration of the drug. It is effective against a wide range of fungi, including Candida albicans, Histoplasma capsulatum, Cryptococcus neoformans, Coccidioides immitis, Blastomyces dermatitidis, and many strains of Aspergillus. In spite of its toxic potential, amphotericin B remains the drug of choice for the treatment of several life-threatening mycoses.
Key Concept:
The diagnosis is rhinocerebral mucormycosis.
Mucormycosis typically occurs in patients with diabetes mellitus, solid organ or hematopoietic stem cell transplantation (HSCT), prolonged neutropenia, or malignancy.
Amphotericin B deoxycholate remains the only licensed antifungal agent for the treatment of mucormycosis. However, lipid formulations of AmB are significantly less nephrotoxic, can be administered at higher doses, and maybe more efficacious than AMB deoxycholate for this purpose.
Reference: Lippincott Illustrated Reviews: Pharmacology Wolters Kluwer Sixth Edition page no 535,536,537