Rhino-orbitocerebral mucormycosis associated with cavernous sinus thrombosis: case report

Abstract

Introduction: Mucormycosis is a rare opportunistic infection caused by Mucorales fungi, and the Rhizopus is the most common one (70% of the cases). It is an acute invasive fungal disease whose form is disseminated, cutaneous, pulmonary, gastrointestinal and rhino-orbitocerebral. The latter is the most common form and its symptoms comprise of unilateral sinusitis, fever and headache. Once established in the orbit the symptoms can be chemosis, diplopia and reduced vision. The infection can spread to the brain via the orbital apex, orbital arteries or via the cribriform plate. Mucormycosis is a medical emergency and the treatment consists of a surgery to an aggressive debridement and in the use of antifungal therapy. Despite the appropriate management, the mortality rate can reach 40% of the cases. One possible intracranial complication of Mucormycosis is the Cavernous Sinus Thrombosis which is a rare and fatal infective disease. The initial symptoms of Cavernous Sinus Thrombosis are headache, retro-orbital pain, periorbital edema, proptosis, diplopia and reduced vision. Case Report: We describe the case of 43-year-old woman with medical history of diabetes mellitus and use of immunosuppressant drugs after kidney transplantation. The patient developed Acute Bacterial Sinusitis and Rhino-orbitocerebral Mucormycosis associated with Cavernous Sinus Thrombosis