Rhinoorbitocerebral mucormycosis: a case report and literature review.
Mucormycosis is a rare oportunistic infection typically described in diabetic patients with a ketoacidotic status, as well as neutropenic patients. The infection is caused by a group of saprophytic fungi of the class Phycomicetes, being the most frequent ones the Rhizomucor, Rhizopus and Mucor. Its hystological findings include vascular trombosis and tissue necrosis, predominantly in the rino-orbito-cerebral area. Even though the frequency of presentation is very low, given its rapid evolution and severe consequences which include a high mortality rate, it is very important to be aware of the main features of the disease and treat it promptly. Although the diagnosis is based on the high clinical suspect, the computed tomography (CT) and the magnetic resonance image (MRI) plays an important role in determining the extension. The patients should receive treatment in a reference hospital so that a multidisciplinary approach is ensured. In this sense, we present a case of rhino-orbito-cerebralmucormycosis in a diabetic patient, recently treated in our Department. A comprehensive review of the literature has been performed to update the physiopathology and diagnosis. Finally, we describe the different treatment options focusing in the surgical approach, as well as the medical treatment with amphotericine and posaconzole.
Martín-Moro
Javier González
JG
Oral and Maxillofacial Surgery Department, La Paz University Hospital, Madrid, Spain. javigmoro@hotmail.com
Calleja
Jose María López-Arcas
JM
García
Miguel Burgueño
MB
Carretero
Jose Luis Cebrián
JL
Rodríguez
Julio García
JG
D000368:Aged; D001927:Brain Diseases / Q000382:microbiology*; D048909:Diabetes Complications / Q000382:microbiology*; D006801:Humans; D008297:Male; D009091:Mucormycosis / Q000150:complications*; D009668:Nose Diseases / Q000382:microbiology*; D009916:Orbital Diseases / Q000382:microbiology*