Rhino-sinus mucormycosis with facial nerve palsy in a child with diabetic ketoacidosis

Abstract

Poorly controlled type 1 diabetes mellitus predisposes the child to opportunistic infections. Mucormycosis is one such infection, Rhino-cerebral form being the most common. Maxillary sinusitis can lead to facial nerve palsy. We report here a 9-year-old boy with poorly controlled diabetes, who presented with left facial swelling and deviation of mouth to the left side in diabetic ketoacidosis. He was diagnosed to have rhinocerebral mucormycosis, maxillary sinusitis, and osteomyelitis with a complication of facial nerve palsy. The child recovered on treatment with IV antifungals and surgical debridement. This case is unique in presentation as fungal rhinocerebral sinusitis with facial nerve palsy highlighting the need of high index suspicion for fungal infection especially in underlying immunocompromised state like T1DM.

Keywords

• diabetic ketoacidosis
• rhinocerebral mucormycosis
• type 1 diabetes