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

M. N. Pitagampola, F. S. Makeen, S. Chandrasiri, P. I. Jayasekara, C. S. P. Sosai, D. Jayasekara, M. Jayasinghe
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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.
病例报告:斯里兰卡三级医院鼻-眶-脑毛霉菌病伴视力损害和脑神经麻痹
毛霉病是一种血管侵入性感染,尤其是在免疫功能低下的患者中。该疾病有几种形式,鼻-眶-脑毛霉菌病是全球最常见的表现,特别是在伴有或不伴有酮症酸中毒的糖尿病患者中。我们报告一个患者鼻-眶-脑毛霉菌病累及多发性脑神经麻痹。一位70岁的女性糖尿病患者,以左眼眶周围肿胀和同侧视力下降并鼻出血为主要表现。经检查,发现她患有多发性脑神经麻痹。在进行了多项微生物学、组织学和放射学检查后,她被诊断为鼻-眶-脑毛霉菌病。患者住院4个月后出院。尽管成功地进行了医疗和手术干预,但该患者在出院一周后死亡。虽然我们没有强有力的证据,但疾病本身、她的合并症、败血症和手术创伤可能是导致她死亡的原因。
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