[Imaging of rhinocerebral mucormycosis].
OBJECTIVE
Rhinocerebal mucormycosis is a rare life threatening fungal infection observed in immunocompromised patients. We report six cases of patients with rhinocerebral mucormycosis confirmed histologically. Our study confirms the necessity of early diagnosis when clinical and CT findings are suggestive.


METHODS
This is a retrospective study including 6 diabetic patients (3 women and 3 men) aged from 28 and 63 years. Five patients had ethmoiditis evolving for a few days (3 to 5 days), and one patient was in an ketoacidotic coma and had a severe infectious syndrome with purulent rhinorrhea evolving for 4 days. All of our patients underwent computed tomography (CT) scan of the paranasal sinuses. MRI was performed in two patients with neurological findings.


RESULTS
Unilateral ethmoido-maxillary sinusitis was noted in 5 cases. Only one case of pansinusitis was found. All patients presented orbital involvement. Cerebral involvement was noted in 4 cases (cerebral venous thrombosis: 2 cases; abscess: 2 cases; cerebral ischemia: 2 cases). The diagnosis of mucormycosis was based on endonasal biopsy. When available, MRI allowed a more precise evaluation of the orbital and cerebral extension.


CONCLUSIONS
Mucormycosis is an opportunist mycosis due to mucoralis fungus. It is very invasive with a highly aggressive potential in diabetic or immunocompromised patients. Imaging study particularly CT scan, plays an important role in diagnosis especially to evaluate cerebral extension.
Mnif
N
N
Service d'Imagerie Médicale, Hôpital Charles Nicolle, 1006 Tunis, Tunisie.
Hmaied
E
E
Oueslati
S
S
Rajhi
H
H
Hamza
R
R
Marrakchi
M
M
Kaffel
N
N
Kooli
H
H
Ben Salah
M
M
Ferjaoui
M
M
D000328:Adult; D001922:Brain Abscess / Q000382:microbiology; D001927:Brain Diseases / Q000382:microbiology*; D002545:Brain Ischemia / Q000382:microbiology; D020226:Cavernous Sinus Thrombosis / Q000382:microbiology; D048909:Diabetes Complications; D003926:Diabetic Coma / Q000150:complications; D016883:Diabetic Ketoacidosis / Q000150:complications; D015521:Ethmoid Sinusitis / Q000382:microbiology; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000382:microbiology; D008279:Magnetic Resonance Imaging; D008297:Male; D015523:Maxillary Sinusitis / Q000382:microbiology; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009916:Orbital Diseases / Q000382:microbiology; D012189:Retrospective Studies; D012852:Sinusitis / Q000382:microbiology*; D014057:Tomography, X-Ray Computed