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Rhino-orbito-cerebral mucormycosis: recovery against the odds
1Department of Neurology, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA.
Practical Neurology
|August 28, 2017
Summary
This case study details a young woman with aggressive rhino-orbito-cerebral mucormycosis, a rare fungal infection. Despite extensive complications and multiple surgeries, she showed significant recovery, highlighting factors influencing survival.
Area of Science:
- Infectious Diseases
- Ophthalmology
- Neurology
Background:
- Rhino-orbito-cerebral mucormycosis (ROCM) is a life-threatening fungal infection.
- Diabetic ketoacidosis is a significant risk factor for ROCM.
Observation:
- A 22-year-old woman presented with diabetic ketoacidosis, sudden blindness, and complete ophthalmoplegia.
- Rapidly progressive infection led to carotid artery occlusion, cavernous sinus thrombosis, cerebral infarctions, and multiple brain abscesses.
Findings:
- Despite extensive disease spread and aggressive surgical debridement including orbital exenteration and craniectomy, the patient showed gradual improvement.
- Long-term antifungal treatment was crucial for recovery.
Implications:
- This case underscores the aggressive nature of ROCM and the necessity of multidisciplinary management.
- Early suspicion, aggressive surgical intervention, and prolonged antifungal therapy are critical for improving outcomes in severe ROCM cases.
- Management of such severe cases involves complex ethical considerations.
