Mucormycosis manifesting as proptosis and unilateral blindness.
A 51-year-old woman presented to the emergency department (ED) of another institution with sudden onset of blindness in the left eye. The patient was found to have no light perception in the left eye and a marked chemosis occurring several days after a fall. She was transferred to the hospital for ophthalmologic evaluation. Upon careful history and physical examination, the diagnosis of rhinocerebral mucormycosis was considered and urgent ophthalmology and otolaryngology consults were obtained. The patient underwent extensive surgical debridement and pharmacologic treatment. The diagnosis was confirmed by pathological specimens. In this case report, the clinical presentation, pathogenesis, diagnostic workup, and ED management of mucormycosis are discussed, highlighting the possible diagnostic and therapeutic pitfalls that are most pertinent to the emergency physician.
Doty
C I
CI
Department of Emergency Medicine, Kings County Hospital Center and State University of New York, Health Science Center at Brooklyn, 11203, USA. dotyc@bigfoot.com
Lucchesi
M
M
D000058:Accidental Falls; D000935:Antifungal Agents / Q000627:therapeutic use; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003646:Debridement; D048909:Diabetes Complications; D004636:Emergency Service, Hospital; D005094:Exophthalmos / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009091:Mucormycosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents