Rhinocerebral mucormycosis in a patient with diabetes type 1 presenting as ptosis and facial palsy report from Alborz hospital of Karaj from Iran

Rhino cerebral mucormycosis (ROCM) is the most common form of mucormycosis in patient with diabetes mellitus. This is an uncommon disease which sometimes presents as symptoms of bacterial or viral sinusitis, otitis, facial palsy, ptosis and earache in a patient with uncontrolled diabetes. The disease presents with a diagnostic dilemma as initial presentation mimics facial or orbital cellulites and ptosis or signs of cavernous sinus thrombosis. Also it has a very rapidly and relentless progressive clinical course and is almost universally fatal if untreated. The authors decided to write up this case because of the need for high index of suspicion in treating patients with this disease. The “black of the palate is widely described as a hallmark of ROCM but the astute clinician will recognize earlier manifestations of this end stage lesion reflecting invasion of the palate.