Rhino-Orbito-Cerebral Mucormycosis with Three Intracranial Complications: Infarct, Hemorrhage and Ophthalmoplegia

Abstract

Rhino-orbito-cerebral mucormycosis is a rare life-threatening opportunistic fungal infection caused by fungi from the order Mucorales [1]. The disease commonly affects immunocompromised patients, especially ketoacidotic diabetic patients [2]. We report a case of Rhinocerebral mucormycosis in a 48-year-old diabetic patient, who presented to our department with the complaints of exophthalmos in the left eye, headache, fever and black nasal discharge (Figure 1A/B). Magnetic Resonance Imaging (MRI) of the brain revealed left ethmoid sinusitis, leftside orbital cellulitis and suggested cavernous sinus thrombosis with left ophthalmic artery occlusion (Figure 2 and Figure 3A). He developed progressive skin necrosis on the left periorbital region within 72 hours of admission (Figure 1C). Diagnosis of mucormycosis was confirmed by mycological findings. Initial empirical antimicrobial therapy was initiated with intravenous cefotaxime 2 g intravenously (IV) every 8 hours, metronidazole 500 mg IV every 8 hours, fosfomycin 4 g IV every 6 hours and injectable amphotericin B. Continuous IV insulin infusion was administered with IV fluids.

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Cite this paper

@inproceedings{Jendoubi2016RhinoOrbitoCerebralMW, title={Rhino-Orbito-Cerebral Mucormycosis with Three Intracranial Complications: Infarct, Hemorrhage and Ophthalmoplegia}, author={Ali Jendoubi}, year={2016} }