Back to Search
Start Over
Imaging features of perineural and perivascular spread in rapidly progressive rhino-orbital-cerebral mucormycosis: A case report and brief review of the literature.
- Source :
-
Surgical neurology international [Surg Neurol Int] 2021 May 31; Vol. 12, pp. 245. Date of Electronic Publication: 2021 May 31 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- Background: Rhinocerebral mucormycosis (ROCM) is an opportunistic fungal infection originating from the paranasal sinuses with extension to the brain. A delayed diagnosis can rapidly result in a poor prognosis. ROCM commonly affects patients with diabetes or immunocompromised states with a variable progression.<br />Case Description: We report the case of a 59-year old patient with an untreated diabetes who developed a ROCM with rapidly progressive neurological symptoms. From the onset of sinus pain, nasal congestion, he rapidly developed facial swelling and masticatory dysfunction. The patient underwent sinus surgery which allowed Rhizopus oryzae to be isolated. Accordingly, a systemic therapy by intensive intravenous amphotericin B was started. Nevertheless, the infection rapidly resulted in bilateral cavernous sinuses thrombosis and occlusion of the left internal carotid artery providing the subsequent patient death.<br />Conclusion: Mucormycosis is a life-threatening fungal infection in diabetic and/or immunosuppressed patients. Our case demonstrates the three main mechanisms for infection spreading that are direct, perineural, and perivascular diffusion. Clear identification of the main risk factors, proper assessment of clinical features, and radiological findings may improve the chance for an early diagnosis and patient survival.<br />Competing Interests: There are no conflicts of interest.<br /> (Copyright: © 2021 Surgical Neurology International.)
Details
- Language :
- English
- ISSN :
- 2229-5097
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- Surgical neurology international
- Publication Type :
- Report
- Accession number :
- 34221576
- Full Text :
- https://doi.org/10.25259/SNI_275_2021