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A 31-year-old Type 1 diabetes mellitus presented with exudative retinal detachment due to rhino-orbital-cerebral mucormycosis secondary to a periodontal abscess developed following a tooth extraction. He received liposomal amphotericin B due to diabetic nephropathy. We report this case for the rarity in the combination of exudative retinal detachment in a case of orbital cellulitis as well for its rarest origin following a dental extraction.

This is a case report of a young male with poorly controlled type 1 diabetes mellitus who presented with the clinical features of diabetic ketoacidosis. On examination, he had severe growth retardation, elevated liver enzymes, advanced diabetic eye disease, and other diabetes-related microvascular complications. Along with the other clinical features, the patient was diagnosed as a case of Mauriac syndrome. Mauriac syndrome, initially described by Mauriac in 1930, is one of the causes of growth retardation and elevated liver enzymes in poorly controlled diabetic patients. Patients with poorly controlled type 1 diabetes must be closely observed for sexual maturation and growth. An early intervention with optimal therapy to bring glycemic control combined with a close follow-up would help avoid such late complications.

Senior Loken syndrome is a rare autosomal recessive genetic disorder. This syndrome mainly targets kidney and eye. Nephronophthisis, a chronic kidney disorder, is the common renal manifestation of this syndrome. End-stage renal disease eventually occurs during adulthood if not intervened. Thus, Senior Loken syndrome is a rare combination of chronic kidney disease, anemia, bronchiectasis, and retinitis pigmentosa. Retinitis pigmentosa that starts in early childhood is the typical ocular manifestation of this syndrome although Leber congenital amaurosis occurs in severe cases. Retinitis pigmentosa is a type of retinal dystrophy affecting mainly rods and cones in a later stage. Although X-linked inheritance causes severe form of retinitis pigmentosa, autosomal recessive is the most common mode of inheritance where retinitis pigmentosa forms part of many systemic syndromes. Night blindness is the presenting symptom which progresses to tubular vision in later stages, with the characteristic fundus features of bony spicule, arteriolar attenuation, and waxy pallor of the disc. Counseling of patient and caretakers about the course of disease and the need for low-vision aids in later stages is vital in retinitis pigmentosa patients. Patients should also be educated about the need for regular nephrology and ophthalmology follow-up to prevent further morbidity.