A Case Report: Rhino-Orbito-Cerebral Mucormycosis with visual impairment and cranial nerve palsies in a tertiary care hospital Sri Lanka

Abstract

Mucormycosis is an angioinvasive infection, especially among immunocompromised patients. There are several forms of the disease and rhino-orbito-cerebral mucormycosis is the commonest presentation globally, especially among patients with diabetes mellitus with or without ketoacidosis. We report a patient with rhino-orbito-cerebral mucormycosis involving multiple cranial nerve palsies. A 70-year-old female patient with uncontrolled diabetes mellitus presented with left periorbital swelling and reduced vision on the same side along with epistaxis. On examination, she was found to have multiple cranial nerve palsies. She was managed as rhino-orbito-cerebral mucormycosis after performing several microbiological, histological, and radiological tests. The patient was discharged after 4 months of hospital stay. Despite successful medical and surgical interventions, the patient died a week after being discharged from the hospital. Though we have no strong evidence, the disease itself, her co-morbidities, sepsis, and surgical trauma could have contributed to her death.

Keywords

• mucormycosis
• diabetes
• cranial nerve palsies
• rhizopus sp
• amphotericin b