title: Brain abscess by mycotic and bacterial infection in a diabetic patient: clinical report and review of literature.
abstract: This report presents a case of lethal invasive mucormycosis, a rare fungal infection, which predominantly affects immunocompromised patients, and is reported in a 57-year-old female who presented with cerebral abscess. The patient, who had undiagnosed diabetes mellitus, presented with extensive right hemifacial deficiency of the bones and soft tissues consequent to surgical resection of the ethmoid-spheno-maxillo-orbital district after mucormycosis. A reconstruction with a pectoral pedunculated flap was performed. The maxillary swelling extended to the contiguous area, involving the palate and homolateral orbital floor. Mucous and cutaneous samples showed the presence of Aspergillus fumigatus, and diagnosis of rhinocerebral mucormycosis was made. The patients also presented with a right hemiplegia consequent to a cerebral abscess by Eikenella corrodens. The authors decided to position an intraoral prosthesis to restore palatal integrity and masticatory function and inserted four titanium fixtures for the retention of the bone-anchored facial prosthesis.
authors.affiliation: Second Faculty of Medicine and Surgery, University of Rome La Sapienza, Azienda Ospedaliera S. Andrea, Maxillo-Facial Surgery, Rome, Italy. v.pellacchia@tiscali.it
authors.forename: Valentina
authors.initials: V
authors.lastname: Pellacchia
authors.forename: Valentina
authors.initials: V
authors.lastname: Terenzi
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Moricca
authors.forename: Sara
authors.initials: S
authors.lastname: Buonaccorsi
authors.forename: Elena
authors.initials: E
authors.lastname: Indrizzi
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Fini
mesh_terms: D001232:Aspergillus fumigatus / Q000502:physiology*; D001922:Brain Abscess / Q000382:microbiology*; D048909:Diabetes Complications / Q000175:diagnosis*; D016124:Eikenella corrodens / Q000502:physiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis*; D006801:Humans; D008443:Maxillary Sinus / Q000382:microbiology; D008447:Maxillofacial Prosthesis; D008875:Middle Aged; D009091:Mucormycosis / Q000601:surgery; D020953:Neuroaspergillosis / Q000175:diagnosis*; D009916:Orbital Diseases / Q000382:microbiology / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000382:microbiology / Q000601:surgery; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures; D013101:Sphenoid Sinus / Q000382:microbiology