Rhinocerebral Mucormycosis – An emerging threat

Abstract

Mucormycosis, also known as Zygomycosis and Phycomycosis, is a rare opportunistic fungal infection with a fulminant course and high mortality rate. Its Rhinocerebral variant is an acute invasive fungal infection which normally affects immunocompromised patients with uncontrolled diabetes, organ transplant and hematological malignancies. It may pose a therapeutic challenge considering the fact that its onset may be followed by rapid progress, extensive involvement and rapid clinical deterioration which may even be fatal. With due regard to such nature of the disease, early diagnosis and aggressive treatment become the cornerstone for better prognosis and survival. Vigilance on the part of the clinician to include Rhinocerebral Mucormycosis as part of the differential diagnosis in susceptible hosts with sino-orbital involvement holds the key. A multimodal treatment strategy comprising of early diagnosis, reversal or stabilization of underlying medical condition, systemic antifungals and surgical debridement has shown best results. This paper reviews the literature on Rhinocerebral Mucormycosis and presents a series of seven cases with their varying predisposing conditions, clinical manifestations and treatment outcome, thus adding to the bank of knowledge on this emerging threat.