Rhino-Orbital Cerebral Mucormycosis

Excerpt

Taxonomically, the term 'zygomycosis' was used to describe invasive fungal infections caused by Zygomycetes, which are ribbon-shaped (about 5-15 microns in diameter) irregularly branched pauciseptate or aseptate molds that reproduce sexually via the formation of zygospores. Subsequently, a reclassification followed, dividing the above species into two orders, Mucorales and Entomopthorales.

The term mucormycosis denotes the acute or subacute rapidly progressing infections caused by the angioinvasive fungi in the order of Mucorales, though there are rare reports of indolent disease. The fungus is unique to cause devastating disease in patients with poorly controlled diabetes mellitus and immunocompromised patients, and often causes significant morbidity and mortality. The rare incidence of mucormycosis in apparently immunocompetent patients has also been documented. The commonest clinical manifestation is rhino-orbital cerebral mucormycosis.

Though mucormycosis exhibits a variety of clinical syndromes with isolated involvement of the gastrointestinal system, skin, kidney, and central nervous system, the commonest and most devastating manifestations are rhino-orbital cerebral, and pulmonary syndromes. Isolated presentations of mucormycosis have also been reported predominantly involving the middle ear, parotid gland, mediastinum, heart and valves, uterus, urinary bladder, and lymph nodes. Disseminated mucormycosis is reported rarely in immunocompromised patients and premature infants.