Rhinocerebral zygomycosis with pansinusitis in a 14-year-old girl with type 1 diabetes: a case report and review of the literature

Ital J Pediatr. 2013 Dec 10:39:77. doi: 10.1186/1824-7288-39-77.

Abstract

Background: Zygomycosis is a rare life-threatening fungal infection affecting mostly patients with predisposing conditions such as diabetes mellitus, immunodeficiency, haemochromatosis or major trauma.

Methods: We describe a case of rhinocerebral zygomycosis in a girl with type 1 diabetes and review previous published cases and treatment options.

Results: A 14-year-old girl with type 1 diabetes mellitus occurred with dental pain, facial swelling, ecchymosis and left eye decreased visual acuity, unresponsive to antibiotic therapy. The cultures of the sinusal mucosa were positive for fungal species belonging to the Zygomycetes. She performed antifungal therapy with posaconazole (POS) with a very slow improvement and a poor glycemic control, leading to blindness of the left eye.

Conclusion: Our report adds further awareness on rhinocerebral zygomycosis and emphasizes on urgent diagnosis and timely management of this potentially fatal fungal infection through an adequate treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Blindness / etiology*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / immunology
  • Disease Progression
  • Electromyography / methods
  • Female
  • Follow-Up Studies
  • Fungemia / diagnosis*
  • Fungemia / drug therapy
  • Fungemia / microbiology
  • Humans
  • Immunocompromised Host
  • Magnetic Resonance Imaging / methods
  • Meningitis, Fungal / diagnosis*
  • Meningitis, Fungal / drug therapy
  • Meningitis, Fungal / microbiology
  • Nose Diseases / diagnosis
  • Nose Diseases / drug therapy
  • Nose Diseases / microbiology
  • Opportunistic Infections / diagnosis*
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Rare Diseases
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Triazoles / therapeutic use
  • Zygomycosis / diagnosis*
  • Zygomycosis / drug therapy
  • Zygomycosis / microbiology

Substances

  • Antifungal Agents
  • Triazoles
  • posaconazole