Rhinocerebral mucormycosis in a diabetic case report

A 40 year old female Nigerian with uncontrolled diabetes mellitus was referred to a teaching hospital with four week history of facial rash that progressed to extensive ulceration of the mid face and bilateral visual loss. She had complete nasal bridge collapse, nasopalatal fistula with black eschars on the mucosa and markedly elevated fasting blood sugar. Her blood glucose was controlled on insulin, She had surgical debridement and histopathological study done revealed fungi hyphae. Systemic antifungal (ketoconazole) was given. Subsequently, she made a slow but steady progress and her wound became clean with healthy granulation tissue. Rhinocerebral mucormycosis still remains a poorly understood disease with high mortality rate. Presently, the triad of clinician's awareness, prompt initiation of treatment and timely surgical intervention represent the effective way of managing the disease.