Rhino-Orbito-Cerebral Mucormycosis with Three Intracranial Complications: Infarct, Hemorrhage and Ophthalmoplegia
نویسنده
چکیده
Rhino-orbito-cerebral mucormycosis is a rare life-threatening opportunistic fungal infection caused by fungi from the order Mucorales [1]. The disease commonly affects immunocompromised patients, especially ketoacidotic diabetic patients [2]. We report a case of Rhinocerebral mucormycosis in a 48-year-old diabetic patient, who presented to our department with the complaints of exophthalmos in the left eye, headache, fever and black nasal discharge (Figure 1A/B). Magnetic Resonance Imaging (MRI) of the brain revealed left ethmoid sinusitis, leftside orbital cellulitis and suggested cavernous sinus thrombosis with left ophthalmic artery occlusion (Figure 2 and Figure 3A). He developed progressive skin necrosis on the left periorbital region within 72 hours of admission (Figure 1C). Diagnosis of mucormycosis was confirmed by mycological findings. Initial empirical antimicrobial therapy was initiated with intravenous cefotaxime 2 g intravenously (IV) every 8 hours, metronidazole 500 mg IV every 8 hours, fosfomycin 4 g IV every 6 hours and injectable amphotericin B. Continuous IV insulin infusion was administered with IV fluids.
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Bilateral Ophthalmic Artery Occlusion in Rhino-Orbito-Cerebral Mucormycosis
PURPOSE To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS Reviewed clinical charts, photographs, and fluorescein angiography RESULTS An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonanc...
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