[Rhinocerebral mucormycosis: report of a rare case in the head-neck and chest area].
Mucormycosis is a severe fungal disease. It can present in two clinical forms: localized or disseminated. The most common, often lethal, form is localized rhinocerebral mucormycosis and is associated with diabetes, debilitation and immunologic deficiencies. The primary location is generally found in the nasal cavity, paranasal sinuses or hard palate. The infective process can extend into the orbita, the cavernosus sinus, the pterygium-palatine and infratemporal fossae with generation of mycotic emboli that can plug the cerebral arteries and, in certain circumstances, can lead to death if it goes untreated. This work describes a clinical case of a 76-years-old patient with a previous history of alcoholism and glucose intolerance, affected by rhinocerebral mucormycosis with extension to the lungs. A general medicine division sent the patient for observation by a specialist since, at the time of hospitalization, objective testing showed signs of an ulcerating lesion of the alveolar edge of the left hemipalate associated with a bilateral pulmonary neoformation suspected to be neoplastic. The patient underwent pulmonary and maxillo-facial surgical resection and medical therapy. The authors discuss the appropriateness of diagnosis and treatment procedures in cases of mucormycosis in association with other pathologies, that can complicate the clinical picture, delaying diagnosis and treatment. The authors point out the need to perform in a short time an adequate medical and surgical treatment of mucormycosis, because of the risk of intracranial extension, leading to an increased mortality, even as high as 80%. The longer it takes to reach a diagnosis the more radical the surgical treatment will need to be.
Neri
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G
Dipartimento di Scienze Chirurgiche Sperimentali e Cliniche, Sezione di Otorinolaringoiatria, Università G. D'Annuzio di Chieti.
Ciardo
M G
MG
Croce
A
A
D000368:Aged; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D008297:Male; D009091:Mucormycosis / Q000382:microbiology* / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed