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.
Department of Ophthalmology, James A. Haley Veterans Hospital, Tampa, Florida, USA. cemargo@mindspring.com
Curtis E
CE
Margo
Craig
C
Linden
Leah B
LB
Strickland-Marmol
Angela L
AL
Denietolis
Judith C
JC
McCaffrey
Nancy
N
Kirk
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