Hyperbaric oxygen therapy for rhinocerebral fungal infection.

Rhinocerebral mucormycosis is an acutely fatal fungal infection that usually arises in the ethmoid sinuses, spreads into the orbits and then into the cranial cavity. It is typically seen in diabetic or immunocompromised patients. Therapy includes aggressive surgical debridement, administration of high-dose amphotericin-B and control of underlying predisposing conditions. Adjunctive hyperbaric oxygen (HBO) is another treatment modality that appears to be promising; oxygen in sufficient concentrations is fungicidal and decreases acidosis thereby increasing tissue survival. It is important for the neuroscience nurse to have an understanding of this deadly infection and the role in preparing the patient for HBO therapy to better plan care.