Rhino-Orbito-Cerebral Mucormycosis: An Infection Still Fatal: A Case Report
Rim El Hachimi *
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Rida EL Hadiri
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Latifa Sbai
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Nihal EL Arari
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Noureddine Boutimzine
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Tachfouti Samira
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Amazouzi Abdellah
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Abdallah EL Hassan
Department of Ophthalmology B, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
Lalla Ouafa Cherkaoui
Department of Ophthalmology A, Mohamed V University of Rabat, Speciality Hospital of Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
We report a case of a 54-year-old patient, an unbalanced diabetic, who presented rhino-orbito-cerebral mucormycosis with orbital involvement as circumstance of discovery. The aims are to highlight the importance of making an early diagnosis to improve prognosis of this infectious pathology. Early diagnosis requires clinical suspicion of infection in all immunocompromised patients, particularly in diabetics with ketoacidosis and clinical research of typical necrotic plaques on the eyelid, palate or sinus level. Histopathological analysis makes diagnosis. Angiography-MRA and angiography-CT scan remain complementary examinations to assess the extension and guide treatment. The management must be multidisciplinary. Association of intravenous antifungal treatment (especially amphotericin B) and localized or radical surgical debridement is the treatment of choice. Local treatment with amphotericin B increases tissue penetration.
Keywords: Mucormycosis, necrosis, fungal infection, filament, amphotericin B