Extent of craniofacial fungal osteomyelitis in a ketoacidotic patient may predict optic nerve involvement: A case report

Int J Surg Case Rep. 2022 Jul:96:107299. doi: 10.1016/j.ijscr.2022.107299. Epub 2022 Jun 13.

Abstract

Introduction: Mucormycosis is an opportunistic mycosis common in poorly-controlled insulin dependent diabetic patients particularly with ketoacidosis. Fungal osteomyelitis is a life-threatening condition affectation of the nose and paranasal sinuses within the orofacial region.

Presentation of case: We present a 63-year-old diabetic male patient with maxillary mucormycotic osteomyelitis threatening his better seeing eye and review the clinical symptoms, relevant imaging, and management.

Discussion: We highlight a rare pattern of craniofacial fungal bone infection with maxillary and orbital involvement that ultimately spared the optic nerve. This case report offers the clinician a review of important clinical and diagnostic findings that can help direct the need for orbital exenteration.

Conclusion: Maxillary mucormycotic osteomyelitis is an aggressive infection that needs to be addressed promptly to prevent fatal consequences.

Keywords: Case report; Diabetes mellitus; Fungal osteomyelitis; Mucormycosis; Opportunistic infection; Otorhinolaryngology.