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[Foudroyant rhinocerebral zygomycosis]
H Sudhoff1, M Wagner, D Theegarten
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, St.-Elisabeth-Hospital, Ruhr-Universität Bochum. Holger.Sudhoff@ruhr-uni-bochum.de
Abstract:
We present a fatal case of rhino-orbital-cerebral zygomycosis in an 81-year old immunocompromised patient with a 18-year history of multiple myeloma. The patient initially presented with symptoms of an orbital complication, loss of vision after acute sinusitis and agranulocytosis. Endonasal sinus surgery with orbital decompression was performed. Within days a rapid visero-cerebral progression of necrosis developed finally causing the patient's death. Invasive fungal infections are generally characterized by diagnostic difficulties in the early stage and exhibit an extremely high mortality. Definitive diagnosis of rhino-orbital-cerebral zygomycosis caused by Rhizopus microsporus was made by histology, culture and polymerase chain reaction. Early diagnosis and treatment are imperative for the management of patients afflicted with this devastating and life-threatening fungal infection.
Insights
This case report details a fatal rhino-orbital-cerebral zygomycosis infection in an 81-year-old immunocompromised patient with multiple myeloma. Early diagnosis and prompt treatment are crucial for managing this aggressive fungal infection.
Area of Science:
- Mycology
- Infectious Diseases
- Oncology
Background:
- Invasive fungal infections pose significant diagnostic challenges and high mortality rates.
- Multiple myeloma patients are immunocompromised, increasing susceptibility to opportunistic infections.
Observation:
- An 81-year-old immunocompromised patient with multiple myeloma presented with orbital complications, vision loss, and agranulocytosis following acute sinusitis.
- Rapid visero-cerebral progression and necrosis occurred despite endonasal sinus surgery and orbital decompression.
Findings:
- Histology, culture, and PCR confirmed rhino-orbital-cerebral zygomycosis caused by Rhizopus microsporus.
- The infection led to a fatal outcome due to rapid progression.
Implications:
- This case underscores the critical need for early diagnosis and aggressive management of invasive fungal infections in immunocompromised individuals.
- Timely intervention is imperative to improve patient outcomes for devastating infections like zygomycosis.