Rhinocerebral Mucormycosis: an Unusual Presentation

Rhinocerebral mucormycosis is one of the most rapidly progressing and lethal form of fungal infection in humans which usually begins in the nose and paranasal sinuses and can extend to CNS. A 68 year old lady with poorly controlled diabetes presented with fever, disorientation, headache and left sided LMN type of facial palsy. ENT examination revealed a palatal ulcer and mucopus in middle meatus. MRI revealed an infarct in the territory of left superior cerebellar artery and haziness and mucosal thickening in the left maxillary and ethmoidal sinuses. Patient underwent endoscopic medial maxillectomy and debridement of palatal ulcer. Postoperative histopathology was suggestive of zygomycosis. Patient was subsequently treated with Amphotericin B for 4 weeks with good recovery. This case is being reported for its rarity as mucormycosis presenting with cerebellar signs has not been reported in the English literature so far.