{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:36:39Z","timestamp":1779312999313,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>This report outlines the case of a woman with rhino-orbital-cerebral mucormycosis following diabetic ketoacidosis, refractory to systemic and local antifungal treatment as well as repeated extensive sinonasal debridement. Adjunctive Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) therapy was associated with significant clinical improvement. This treatment restored visual acuity, and the excellent outcomes were maintained at the 24-month follow-up. This is the first report of successful use of a short course (5 days) of GM-CSF for refractory rhino-orbital cerebral mucormycosis in an adult patient after diabetic ketoacidosis, highlighting the therapeutic potential of this pragmatic approach.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1620545","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:39:17Z","timestamp":1758087557000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Immune-modulating therapy with granulocyte-macrophage colony-stimulating factor (GM-CSF) in refractory rhino-orbital-cerebral mucormycosis \u2013 a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Piremiya","family":"Thayanantham","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Kalin-Hajdu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Dufresne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe J.","family":"Dufresne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Viau-Lapointe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan-Alexis","family":"Tremblay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2021.03.009","article-title":"Mucormycosis","volume":"35","author":"Steinbrink","year":"2021","journal-title":"Infect Dis Clin North Am"},{"key":"B2","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.cmi.2018.07.011","article-title":"The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports","volume":"25","author":"Jeong","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium","volume":"19","author":"Cornely","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/jof4030090","article-title":"Therapy of mucormycosis","volume":"4","author":"Sipsas","year":"2018","journal-title":"J Fungi"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1086\/590004","article-title":"Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic Malignancy who have zygomycosis","volume":"47","author":"Chamilos","year":"2008","journal-title":"Clin Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir865","article-title":"Pathogenesis of mucormycosis","author":"Ibrahim","year":"2012","journal-title":"Clin Infect Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005270","article-title":"Immune profiling demonstrates a common immune signature of delayed acquired immunodeficiency in patients with various etiologies of severe injury","volume":"50","author":"Venet","year":"2022","journal-title":"Crit Care Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3390\/jof6030173","article-title":"Host immune defense upon fungal infections with mucorales: pathogen-immune cell interactions as drivers of inflammatory responses","volume":"6","author":"Monta\u00f1o","year":"2020","journal-title":"J Fungi"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/BF01691218","article-title":"Role of granulocyte colony-stimulating factor in the treatment of mucormycosis","volume":"15","author":"Sahin","year":"1996","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.580250","article-title":"A longitudinal study of immune cells in severe COVID-19 patients","volume":"11","author":"Payen","year":"2020","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2018.02.014","article-title":"Mucormycosis in Iran: A six-year retrospective experience","volume":"28","author":"Dolatabadi","year":"2018","journal-title":"J Med Mycol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/jof5010026","article-title":"Global epidemiology of mucormycosis","volume":"5","author":"Prakash","year":"2019","journal-title":"J Fungi (Basel)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1086\/432579","article-title":"Epidemiology and outcome of zygomycosis: a review of 929 reported cases","volume":"41","author":"Roden","year":"2005","journal-title":"Clin Infect Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1186\/s13256-024-04873-w","article-title":"The first report of rhinosinusitis by Rhizopus delemar in a patient with severe COVID-19 in Iran: a case report","volume":"18","author":"Mojtahedi","year":"2024","journal-title":"J Med Case Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e0123021","DOI":"10.1128\/JCM.01230-21","article-title":"Epidemiology and antifungal susceptibilities of mucoralean fungi in clinical samples from the United States","volume":"59","author":"Badali","year":"2021","journal-title":"J Clin Microbiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.ajo.2021.05.025","article-title":"Outcomes of a modified treatment ladder algorithm using retrobulbar amphotericin B for invasive fungal rhino-orbital sinusitis","volume":"237","author":"Ashraf","year":"2022","journal-title":"Am J Ophthalmol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"ofac535","DOI":"10.1093\/ofid\/ofac535","article-title":"Recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF) as adjuvant therapy for invasive fungal diseases","volume":"9","author":"Chen","year":"2022","journal-title":"Open Forum Infect Dis"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1620545\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:39:18Z","timestamp":1758087558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1620545\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":17,"alternative-id":["10.3389\/fimmu.2025.1620545"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1620545","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"article-number":"1620545"}}