Efficacy of Two-phase Treatment Regimen for Rhino-facial Entomophthoromycosis: Our Experience and Review of Literature

This paper reviews our institutional experience in the management of rhino-facial entomophthoromycosis, a rare subcutaneous fungal infection. We adopt a fixed two-phase protocol comprising an initial ‘intensive phase’ (two-drug regimen) followed by an ‘eradication phase’ (monotherapy). We present five patients treated between May 2013 and May 2020 in our institution who were subjected to the mentioned protocol. All five patients received six months of supersaturated potassium iodide solution and itraconazole, followed by four months of monotherapy with only supersaturated potassium iodide solution. All patients responded well to the treatment and were disease-free on follow-up of a minimum two years post-treatment. We recommend this procedure for all typical cases of entomophthoromycosis and suggest avoiding surgical intervention which may disseminate the fungus and delay response to treatment.