Rhino-Orbital Cerebral Mucormycosis in a Healthy Female Child: Case Report

Abdisalam Abdullahi Yusuf,1 Ismail Gedi Ibrahim,2,3 Ibrahim Mohamed Hirsi,1 Ali Adali,1 Yonis Yusuf Hassan,1 Mehmet Zeki Yasar,1 Ismail Mohamoud Abdullahi,4 Mohamed Sheikh Hassan3,5 1Department of Pediatric, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia; 2Department of Radiology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia; 3Faculty of Medicine and Surgery, Mogadishu University, Mogadishu, Somalia; 4Department of Pathology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia; 5Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Abdisalam Abdullahi Yusuf, Email taqi1434@gmail.comAbstract: Mucormycosis is a potentially fatal condition with a high mortality rate, particularly when there is extra nasal involvement, and it is rare for patients with fungal brain disease to survive. It mostly affects patients who are metabolically or immunologically compromised, which constitutes one of the three classical stages of the progression of Rhino-Orbito-Cerebral Mucormycosis (ROCM). Stage I: infection of the nasal mucosa and paranasal sinuses; Stage II: orbital involvement; Stage III: cerebral involvement.Here, we report a case of rhino-orbital cerebral mucormycosis in a 14-year-old girl with no known risk factor who presented with periorbital edema, right eye proptosis, fever, and extreme facial pain, which progressively worsened to confusion and left leg weakness in 3 days after admission. The final diagnosis was rhino-orbital-cerebral mucormycosis. The infection was successfully treated using liposomal amphotericin and surgical debridement to remove infected orbital tissue. Mucormycosis is a potentially fatal disease that necessitates prompt diagnosis and treatment. Children are rarely infected with mucormycosis. The majority of studies show that people are typically between 40 and 50 years old. ROCM is typically diagnosed using clinical symptoms and histopathologic evaluation; however, imaging is critical in determining the presence of intracranial lesions. The standard treatment for ROCM is amphotericin B at a recommended dose of 1.0– 1.5 mg/kg/day for weeks or months, depending on the clinical response and severity of adverse drug reactions, particularly nephrotoxicity.Rhino-orbital cerebral mucormycosis in a healthy female child is uncommon; early diagnosis and prompt treatment with Amphotericin B should be necessary. Devastating consequences will result from a delayed diagnosis.Keywords: mucormycosis, orbital cellulitis, liposomal amphotericin B, cerebral involvement