Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec 23:8:5-9.
doi: 10.1016/j.mmcr.2014.12.002. eCollection 2015 Jun.

Invasive rhino-orbito-cerebral mucormycosis in a diabetic patient - the need for prompt treatment

Vanessa Chow  1 , Sheema Khan  2 , Adeola Balogun  2 , David Mitchell  1 , Fritz A Mühlschlegel  3
Affiliations

Invasive rhino-orbito-cerebral mucormycosis in a diabetic patient - the need for prompt treatment

Vanessa Chow et al. Med Mycol Case Rep. .

Abstract

Mucormycosis is a rare life threatening fungal infection predominately seen in immunocompromised or diabetic patients. The following case is of a known type II diabetic patient who presented with sepsis and sudden unilateral loss of vision secondary to infective rhino-orbito-cerebral mucormycosis. Treatment of the condition required extensive surgical intervention and medical management for a life saving outcome.

Keywords: Deferasirox; Liposomal amphotericin B (AmBisome); Mucorales; Posaconazole; Rhinocerebral mucormycosis; Rhizopus arrhizus.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Endoscopic photography of left nasal cavity demonstrating black eschar (dead tissue) indicated by the arrow on the left lateral nasal wall.
Fig. 2
Fig. 2
Coronal CT image without contrast showing thickening of mucosa and opacification of left ethmoidal and maxillary sinuses (indicated by the arrow).
Fig. 3
Fig. 3
Diffusion weighted MRI axial imaging showing extensive inflammatory changes in the left nasal cavity and paranasal sinuses with mass encroaching into left orbital plate (indicated by arrow).
Fig. 4
Fig. 4
Woolly colonies, known colloquially as ‘lid lifters’.
Fig. 5
Fig. 5
(a) Direct fluorescence microscopy on excised tissue. Microscopic image of Rhizopus arrhizus with broad hyphae and irregular branching with Calcofluor white stain. (b) Haematoxylin and eosin stain of Rhizopus arrhizus.
Fig. 6
Fig. 6
Image of enucleated left eye.
Fig. 7
Fig. 7
Vasculitis consistent with inflammatory response to mucor angio-invasion (magnification x100).
See this image and copyright information in PMC

References

    1. M.T. Yen, W.P. Baugh, Rhinocerebral Mucormycosis [Internet], [Place unknown]: Medline, 2011. Avaliable from: 〈http://emedicine.medscape.com/article/227586-overview〉 (Updated 08.12.11).
    1. Saegeman V., Maertens J., Meersseman W., Spriet I., Verbeken E., Lagrou K. Vol. 16. University Hospital, Belgium; 2010. Increasing Incidence of Mucormycosis. pp. 1456–1458 (dispatch) - PMC - PubMed
    1. Bitar D., Van Cauteren D., Lanternier F., Dannaoui E., Che D., Dromer F. Increasing incidence of zygomycosis (mucormycosis), France, 1997–2006. Emerg. Infect. Dis. 2009;15:1395–1401. - PMC - PubMed
    1. Petrikkos G., Skiada A., Lortholary O., Roilides E., Walsh J.T., Kontoyiannis D.P. Epidemiology and clinical manifestations of mucormycosis. Clin. Infect. Dis. 2012;54(1):23–34. - PubMed
    1. Yohai R.A., Bullock J.D., Aziz A.A., Markert R.J. Survival factors in rhino-orbital-cerebral mucormycosis. Surv. Ophthalmol. 1994;39(1):3–22. - PubMed

LinkOut - more resources