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Orbital complications of fungal pan-sinusitis in uncontrolled diabetes
Miruna Nicolae1, Cristian Radu Popescu1, Bogdan Popescu1
1ENT, Department of Head and Neck Surgery, Coltea Clinic Hospital, Bucharest, Romania.
Abstract:
The purpose of our clinical case presentation is to emphasize the role of ear, nose and throat specialist in early recognition and urgent treatment of mucormycosis, which is a rare infection caused by fungus belonging to the order Mucorales. They are known opportunistic organisms, which potentially invade and infect a host with depressed immunity. In our paper we present a case of an uncontrolled diabetic male with orbital complications caused by a fungal pan-sinusitis. The typical presentation of rhino-orbital fungal infection is that of anterior orbital inflammation, severe visual loss, external ophthalmoplegia and fever. Our diagnostic was based on an otolaryngological, ophthalmological, imagistic but especially biopsy exam, which is the only one that can make the certain diagnostic in this case. We followed the standard treatment for these situations. Early recognition and treatment with urgent surgical debridement and systemic antifungal therapy is the key to the management of rhino-orbital mucormycosis and is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease.The authors certify that they do not have any financial or personal relationships that might bias the content of this work.
Insights
Early recognition and treatment by ear, nose, and throat specialists are crucial for managing rhino-orbital mucormycosis, a rare fungal infection. Prompt surgical debridement and antifungal therapy are key to improving outcomes and reducing mortality.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Ophthalmology
Background:
- Mucormycosis is a rare, opportunistic fungal infection caused by Mucorales, primarily affecting immunocompromised individuals.
- Rhino-orbital mucormycosis presents with severe symptoms including visual loss and ophthalmoplegia, often stemming from fungal pan-sinusitis.
Observation:
- A case of uncontrolled diabetes mellitus presented with orbital complications secondary to fungal pan-sinusitis.
- Diagnostic methods included otolaryngological and ophthalmological examinations, imaging, and biopsy, with biopsy being definitive.
Findings:
- Fungal pan-sinusitis led to orbital complications in an uncontrolled diabetic patient.
- Biopsy confirmed mucormycosis, necessitating prompt intervention.
Implications:
- Early diagnosis and urgent surgical debridement combined with systemic antifungal therapy are critical for managing rhino-orbital mucormycosis.
- Increased awareness among healthcare practitioners regarding the signs and symptoms of mucormycosis is essential to prevent high morbidity and mortality.
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