Fungal central skull-base osteomyelitis: atypical presentation and management issues

Mucormycosis is a very commonly encountered disease in the sinonasal region patients with diabetes and immunocompromised status specially northern part of Indian continent. Due to its fulminant nature involvement rhino-orbital-cerebral region, prognosis poor even after extensive debridement amphotericin-B therapy. We present case diagnosis sarcoidosis being treated systemic steroids who developed sudden-onset ptosis left lateral rectus palsy. On radiological evaluation MRI, heterogenously peripherally enhancing lesion was seen nasopharynx suggestive nasopharyngeal abscess. The patient taken up for emergency surgery; necrotic destruction sphenoid bone, pterygoids clivus originating nasopharynx. on fungal staining came out be broad aseptate hyphae mucormycosis.