Lethargy and vision loss: successful management of rhinocerebral mucormycosis

BMJ Case Rep. 2016 Jun 2:2016:bcr2016215855. doi: 10.1136/bcr-2016-215855.

Abstract

Rhinocerebral mucormycosis (RCM) is an angioinvasive fungal infection most often caused by Rhizopus oryzae It is usually associated with an underlying risk factor and is associated with a poor prognosis. There are no consensus guidelines on the optimal management of this aggressive disease; most management decisions are based on case reports and expert opinion. We report a successfully managed case of RCM in an insulin-dependent diabetic, initially presenting with a change in mental status, rapidly progressing to complete right eye blindness and ophthalmoplegia and complicated by multiple cerebral infarctions and abscesses. We describe the diagnostic approach and various therapeutic interventions undertaken to successfully manage our patient.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Blindness / etiology*
  • Brain / diagnostic imaging
  • Brain Abscess
  • Diabetes Mellitus, Type 1 / complications
  • Diabetic Ketoacidosis / complications
  • Female
  • Humans
  • Lethargy / etiology*
  • Mucormycosis / diagnosis*
  • Mucormycosis / drug therapy
  • Paranasal Sinus Diseases / diagnosis*
  • Paranasal Sinus Diseases / drug therapy
  • Rhizopus / isolation & purification*
  • Risk Factors
  • Young Adult

Substances

  • Antifungal Agents