Rhino-Orbito-Cerebral Mucormycosis

Purpose: A case of rhino-orbito-cerebral mucormycosis with uncontrolled diabetes mellitus (DM) was presented in the light of literature. Material and Methods: Triple systemic antibiotics, anticoagulant therapy and functional endoscopic sinus surgery were performed to the patient applied with the complaints of pansinusitis and its complication, partial cavernous sinus thrombosis. One month later upon the development of left peripheral facial paralysis, aphasia, right hemiparesis, ptosis, total ophthalmoplegia and loss of vision; mucormycosis was diagnosed through magnetic resonance imaging and histopathological examination. Results: Parenteral Amphotericin B therapy was started to the patient. Thereby diabetes mellitus was regulated. After the treatment, patient's general condition improved. Conclusion: Rhino-orbital-cerebral mucormycosis is an uncommon, acute and aggressive fungal infection occurring in several immunocompromised states including diabetes, malignancy or taking immunosuppressive agents. Morbidity and mortality are very high due to the angioinvasive property of the fungus. Our patient, who could survive despite of the internal carotid artery thrombosis, is one of the rarest cases in the literature. Comprehensive surgical debridement of all infected tissues, cure of the underlying disease and administration of amphotericin B are the three main components of the treatment.