title: Lethargy and vision loss: successful management of rhinocerebral mucormycosis.
abstract: Rhinocerebral mucormycosis (RCM) is an angioinvasive fungal infection most often caused by Rhizopus oryzae It is usually associated with an underlying risk factor and is associated with a poor prognosis. There are no consensus guidelines on the optimal management of this aggressive disease; most management decisions are based on case reports and expert opinion. We report a successfully managed case of RCM in an insulin-dependent diabetic, initially presenting with a change in mental status, rapidly progressing to complete right eye blindness and ophthalmoplegia and complicated by multiple cerebral infarctions and abscesses. We describe the diagnostic approach and various therapeutic interventions undertaken to successfully manage our patient.
authors.affiliation: Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Ramzi
authors.initials: R
authors.lastname: Mulki
authors.affiliation: Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Masab
authors.affiliation: Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Eiger
authors.affiliation: Division of Infectious Diseases, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Perloff
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology*; D001921:Brain / Q000000981:diagnostic imaging; D001922:Brain Abscess; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D016883:Diabetic Ketoacidosis / Q000150:complications; D005260:Female; D006801:Humans; D053609:Lethargy / Q000209:etiology*; D009091:Mucormycosis / Q000175:diagnosis* / Q000188:drug therapy; D010254:Paranasal Sinus Diseases / Q000175:diagnosis* / Q000188:drug therapy; D012233:Rhizopus / Q000302:isolation & purification*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000935:Antifungal Agents