Rhinocerebral mucormycosis: case report.
Rhinocerebral mucormycosis is a rare, fulminating opportunistic fungal infection caused by a fungus of the order mucorales. These fungi are ubiquitous, subsisting on decaying vegetation and diverse organic material. Although the fungi and spores of mucorales show minimal intrinsic pathogenicity towards normal persons, they can initiate aggressive and fulminating infection in the immune compromised host. Because rhinocerebral mucormycosis occurs infrequently it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation. We present a patient with classical presentation of rhinocerebral mucormycosis involving the paranasal sinuses, the orbit and cranial base who, was treated by a combination of aggressive surgical and medical therapy and subsequently had surgical repair of the oral defect. The purpose of this presentation is to draw attention to the clinical presentation and pathogenesis of rhinocerebral mucormycosis and to emphasise the need for high index of suspicion in its diagnosis and management.
Onyango
J F
JF
Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Nairobi, Nairobi, Kenya.
Kayima
J K
JK
Owen
W O
WO
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000382:microbiology; D006429:Hemiplegia / Q000382:microbiology; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D009668:Nose Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D009916:Orbital Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010254:Paranasal Sinus Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D035583:Rare Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D019291:Skull Base; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B