Rhinocerebral mucormycosis with perineural spread.
We describe the histopathologic findings of perineural invasion in orbital mucormycosis in a man with diabetes in ketoacidosis. Linear enhancement on MRI beginning at the orbital apex was correlated with fungal tracking of the trigeminal and lacrimal nerves. Mucormycosis can spread considerable distances from its primary focus of infection along peripheral nerves, a phenomenon that can be identified clinically with contrast-enhanced MRI.
Margo
Curtis E
CE
Department of Ophthalmology, James A. Haley Veterans Hospital, Tampa, Florida, USA. cemargo@mindspring.com
Linden
Craig
C
Strickland-Marmol
Leah B
LB
Denietolis
Angela L
AL
McCaffrey
Judith C
JC
Kirk
Nancy
N
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005005:Ethmoid Sinus / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007765:Lacrimal Apparatus / Q000294:innervation; D008297:Male; D008875:Middle Aged; D009090:Mucorales / Q000302:isolation & purification; D009091:Mucormycosis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013508:Ophthalmologic Surgical Procedures; D009916:Orbital Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D013101:Sphenoid Sinus / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D014230:Triazoles / Q000627:therapeutic use; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B