Sudden vision loss caused by rhino-orbital zygomycosis in diabetic patients: case series.
Rhino-orbital zygomycosis is a life-threatening fungal infection generally occurring in patients with an underlying disorder, such as diabetes mellitus with ketoacidosis or with immunocompromising factors, although it may rarely appear in healthy individuals. The study has been undertaken to discuss the clinical presentation, pathogenesis, diagnostic work up and management of this rapidly progressive disease. Four male patients having uncontrolled diabetes and presenting with signs and symptoms of rhino-orbital zygomycosis were studied to illustrate the serious nature of the disease. All the four patients had rapidly deteriorating vision loss either unilateral or bilateral along with other nasal and orbital signs and symptoms. All the patients were put on liposomal amphotericin B and underwent orbital exenteration and pansinusectomy. One patient died, while the other three were successfully treated. Early diagnosis is critical in the prevention of morbidity and mortality associated with the disease. There is need for a high index of clinical suspicion in immunocompromised patients. Timely medical-surgical treatment proves extremely important for prognosis.
Chander
J
J
Kaur
J
J
Gulati
N
N
Arora
V
V
Nagarkar
N
N
Sood
S
S
Mohan
H
H
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D001766:Blindness / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D048909:Diabetes Complications / Q000175:diagnosis* / Q000473:pathology*; D015353:Eye Enucleation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D009916:Orbital Diseases / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D020096:Zygomycosis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy
D000935:Antifungal Agents; D000666:Amphotericin B