Rhinocerebral Mucormycosis

Abstract

Recently, the incidence of opportunistic fungal infections has increased due to a rise in conditions with a general impairment of immunity. These are serious disorders that can be diagnosed and treated with difficulty and have an unfavourable prognosis. A case of a 45-year-old diabetic patient with late determination of rhinocerebral mucormycosis of peracute course and fatal termination is presented. The patient was treated with surgery and antibiotics, and the diagnosis was established postmortem. If rhinocerebral mucormycosis is suspected (immunodeficiency, temperatures which do not respond to antibiotic treatment, black crusts in the nose, unilateral headache, symptoms of orbitocellulitis and endocranial complications), a biopsy must be taken from the margin of a necrotic lesion. If non-septated hyphae with rectangular branching are found, it is necessary to start a complete therapy attempting to adjust the general condition, aggressive surgical debridement and the intravenous administration of amphotericin B at a dose of 0.25–0.30 mg/kg/day or the liposomal form of amphotericin B, 3–4 mg/kg/day, at first daily, then every other day.