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Lack of efficacy: case report A 34-year-old man exhibited lack of efficacy during treatment with amphotericin-B for cerebral mucormycosis (Zygomycosis). The man presented with bifrontal headache especially in the morning for 4-5 days. He developed progressive left side weakness over 2 days. On admission in an emergency department, he was unconscious with an extensor response with laboured breathing. His-both pupils were dilated, and the right pupil was not reacting to light. He had a recent history of mild COVID-19 pneumonia. Further, he underwent brain MRI which showed a non-enhancing mass lesion involving the right basal ganglia and insular cortex with petechial hemorrhages and small patches of restricted diffusion. It was causing severe mass effect with subfalcine herniation. The lesion was thought to be due to focal cerebritis due to fungal or viral source versus a glial-origin tumor. His condition was deteriorating rapidly neurologically, probably due to mass effect, and he was taken up for emergency decompressive craniectomy and excision biopsy of the lesion. Intraoperatively, the brain was diffusely swollen. The lesion was seen as a friable, suckable mass with the poor plane

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Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)