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Rhino-orbital-cerebral mucormycosis in type 1 diabetes mellitus
S Bhadada1, Anil Bhansali, K S S Reddy
1Department of Endocrinology, PGIMER, Chandigarh, India.
Indian Journal of Pediatrics
|September 1, 2005
Summary
Rhino-orbital-cerebral mucormycosis (ROCM) in adolescents with type 1 diabetes mellitus (T1DM) presents with severe symptoms like proptosis and vision loss. Early suspicion and combined treatment with amphotericin B and surgery improve outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Endocrinology
Background:
- Adolescents with type 1 diabetes mellitus (T1DM) are at risk for opportunistic infections.
- Rhino-orbital-cerebral mucormycosis (ROCM) is a rare but aggressive fungal infection.
Observation:
- A retrospective analysis of six T1DM patients with ROCM was conducted.
- Common symptoms included proptosis and ptosis; common signs were ophthalmoplegia and vision loss.
- Maxillary sinus involvement was frequent (85%).
Findings:
- Four patients presented with ROCM, while two developed it during hospitalization.
- All patients received amphotericin B, and most underwent surgery.
- Four patients survived; poor outcomes were associated with altered sensorium, facial necrosis, palatal perforation, and cerebral involvement.
Implications:
- A high index of suspicion for ROCM is crucial in T1DM patients.
- Combined therapy with amphotericin B and surgical debridement offers the best chance of survival.
- Prompt diagnosis and multidisciplinary management are essential for improving patient outcomes.