SIADH secondary to rhino-orbito-cerebral mucormycosis: A case report

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL

Clinical Case Reports Pub Date : 2024-11-12 DOI:10.1002/ccr3.9491

Bibek Shrestha, Pradeep Shrestha, Prabin Shrestha, Sudip Bastakoti, Prahlad Gupta, Shiva Ram Ale Magar

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引用次数: 0

Abstract

Key Clinical Message

Invasive fungal mucormycosis and its outcome as SIADH and orbital apex syndrome is uncommon. Mucormycosis in paranasal sinuses can even lead to intracranial invasion and its treatment with the use of amphotericin B can cure improve the prognosis of the disease. Early diagnosis and prompt treatment with antifungal, endoscopic surgery, and controlling of diabetes can be beneficial.

Mucormycosis is an opportunistic invasive fungal infection which is rare and fatal and can even cause intracranial invasion leading to SIADH. The infrequency with which mucormycosis with SIADH is encountered makes it a formidable diagnostic challenge. 70-year-old women uncontrolled diabetes mellitus presented with bilious vomiting and persistent headache with ptosis, proptosis, absence of extraocular movement, pupillary light reflex, and light perception of left eye. Radiographic investigation, KOH mount, and Biopsy showed mucormycosis in sinus with intracranial extension leading to SIADH. Further investigation revealed hyponatremia, decreased plasma osmolality. Then, when diabetes was controlled and hydrocortisone and amphotericin was given along with Endoscopic sinus debridement, SIADH was well controlled. This case illustrates the potential of mucormycosis in paranasal sinuses can even lead to intracranial invasion and its treatment with the use of amphotericin B can cure improve the prognosis of the disease. Prompt diagnosis through clinical history, radiological investigation, and laboratory parameters are important and its treatment is crucial for the better prognosis.

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继发于鼻-轨道-脑粘液瘤病的 SIADH：病例报告。

关键临床信息：侵袭性真菌粘孢子菌病及其导致的SIADH和眶顶综合征并不常见。鼻旁窦粘孢子菌病甚至可导致颅内侵犯，使用两性霉素 B 治疗可改善疾病的预后。摘要：粘孢子菌病是一种机会性侵袭真菌感染，罕见且致命，甚至可引起颅内侵犯，导致 SIADH。粘孢子菌病并发 SIADH 的情况并不常见，因此是一项艰巨的诊断挑战。70 岁的女性糖尿病患者因胆汁性呕吐和持续性头痛、眼睑下垂、眼球外运动、瞳孔对光反射和左眼光感缺失而就诊。影像学检查、KOH涂片和活组织检查显示，鼻窦粘液瘤病并向颅内扩展，导致SIADH。进一步检查发现患者出现低钠血症，血浆渗透压下降。随后，糖尿病得到控制，并给予氢化可的松和两性霉素以及内窥镜鼻窦清创术，SIADH 得到了很好的控制。本病例说明，鼻旁窦粘液瘤病甚至可能导致颅内侵犯，使用两性霉素 B 治疗可以改善疾病的预后。通过临床病史、放射学检查和实验室指标进行及时诊断非常重要，而治疗则是改善预后的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Case Reports MEDICINE, GENERAL & INTERNAL-

自引率

14.30%

发文量

1268

审稿时长

13 weeks

期刊介绍： Clinical Case Reports is different from other case report journals. Our aim is to directly improve global health and increase clinical understanding using case reports to convey important best practice information. We welcome case reports from all areas of Medicine, Nursing, Dentistry, and Veterinary Science and may include: -Any clinical case or procedure which illustrates an important best practice teaching message -Any clinical case or procedure which illustrates the appropriate use of an important clinical guideline or systematic review. As well as: -The management of novel or very uncommon diseases -A common disease presenting in an uncommon way -An uncommon disease masquerading as something more common -Cases which expand understanding of disease pathogenesis -Cases where the teaching point is based on an error -Cases which allow us to re-think established medical lore -Unreported adverse effects of interventions (drug, procedural, or other).