Rhinocerebral Mucormycosis: an Unusual Presentation

Rajeshwari A,Gangadhara Somayaji K S

doi:10.5923/j.ajmms.20120201.04

Rajeshwari A, Gangadhara Somayaji K S

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https://doi.org/10.5923/j.ajmms.20120201.04

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Abstract

Rhinocerebral mucormycosis is one of the most rapidly progressing and lethal form of fungal infection in humans which usually begins in the nose and paranasal sinuses and can extend to CNS. A 68 year old lady with poorly controlled diabetes presented with fever, disorientation, headache and left sided LMN type of facial palsy. ENT examination revealed a palatal ulcer and mucopus in middle meatus. MRI revealed an infarct in the territory of left superior cerebellar artery and haziness and mucosal thickening in the left maxillary and ethmoidal sinuses. Patient underwent endoscopic medial maxillectomy and debridement of palatal ulcer. Postoperative histopathology was suggestive of zygomycosis. Patient was subsequently treated with Amphotericin B for 4 weeks with good recovery. This case is being reported for its rarity as mucormycosis presenting with cerebellar signs has not been reported in the English literature so far.

Highlights

Mucormycosis is a fatal opportunistic infection caused by the fungi of the order mucorales which includes mucor, rhizopus, absidia and others.[1]
Rhizopus oryzae is the predominant pathogen accounting for 60% of all the forms of mucormycosis and 90% of rhinocerebral cases
We are reporting a case of mucormycosis, presented with cerebellar signs, which has not been reported in the English literature so far

Summary

Introduction

Mucormycosis is a fatal opportunistic infection caused by the fungi of the order mucorales which includes mucor, rhizopus, absidia and others.[1]. Rhizopus oryzae is the predominant pathogen accounting for 60% of all the forms of mucormycosis and 90% of rhinocerebral cases. This disease usually develops in patients who are metabolically or immunologically compromised; but at times can be seen in otherwise healthy individuals.[2] Mucormycosis can manifest as one of six different clinical syndromes; rhinocerebral, pulmonary, cutaneous, gastrointestinal, central nervous system and disseminated. There was a history of swelling and pain over the left side of the face and deviation of the angle of the mouth to right side of 2 days duration. There was a history of swelling and pain over the left side of the face and deviation of the angle of the mouth to right side of 2 days duration. (Fig No.1)

Case report

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