Rhinocerebral mucormycosis with therapeutic challenges encountered in a rural resource constrained setting

Abstract

Abstract Introduction Rhinocerebral mucormycosis is the most serious, rapidly progresmortality rate of 70%–100% if not treated adequately and most commonly manifests itself in the setting of poorly controlled diabetes mel-litus especially with ketoacidosis. Rapid progression and high mortal-ity necessitate prompt recognition and aggressive treatment to increase survival rate. We present a case of rapidly pro-gressive rhinocerebral mucormycosis in a 17-year-old girl with ketoaci-dotic type 1 diabetes mellitus. The case exemplifies the therapeutic challenges encountered in a rural resource constrained setting. Case report A 17-year-old girl was brought to the emergency department of our hospi-tal with the complaint of breathing difficulty for the last three days. On admission she was febrile (39.1°C), had facial puffiness, marked left-sided hemifacial oedema, periorbital oedema, unilateral mucopurulent rhinorrhea, had acidotic breath and difficulty in breathing. On physi-cal examination, nasal wall and the upper lip showed necrotic lesions (more so) on the left side, also necrotic mucosal lesions in the oral and nasal cavity were evident.