Pterygopalatine Fossa: A Way to Spread Mucormycosis with Multiple Cranial Nerve Involvement

Abstract

Background: Mucormycosis is a rare, aggressive, and fatal infection caused by fungi of the Mucorales order of Zygomycete fungi. Mucormycosis is mainly found in patients with chronic conditions, and clinical cases are observed only in immunocompromised patients and patients with uncontrolled diabetes mellitus. Rhinocerebral type is the most prevalent type of mucormycosis which has a characteristic method of spread. Although the involvement of cranial nerves is not common, it can be multiple with facial nerve involvement. Case Presentation: We described an unusual route of fungus spread in a 50-year-old woman with the involvement of many cranial nerves, without obvious necrosis or significant involvement of paranasal sinuses. Pterygopalatine fossa was a way to spread mucormycosis. Conclusion: In every diabetic patient with cranial nerve palsy and sinusitis, invasive mucormycosis must be considered.