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Rhino-Orbital-Cerebral Mucormycosis: A Rare Complication of Uncontrolled Diabetes
Rahaf F Alanazi1,2, Abdulrahman Almalki2,3, Ali Alkhaibary1,2,3
1College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
Fungal infection of the central nervous system has become more common over the past two decades. It is frequently diagnosed in patients with underlying pathological conditions. We herein report a case of rhino-orbital-cerebral mucormycosis by outlining the clinical presentation, radiological images, histopathological findings, management plan, and its clinical outcome. Case Description. A 47-year-old man, known to have type 2 diabetes mellitus, presented with severe headache involving the left side of the face, numbness along the left V2 trigeminal nerve, ptosis and dryness of the left eye, short-term memory loss, and right hand numbness. He had a social history of being a bee farmer for which he was exposed to bee stings several times in the past. Neuroradiological imaging showed a left temporal ring-enhancing lesion, suggestive of abscess. The patient underwent craniotomy and resection of the lesion. The histopathological evaluation was suggestive of cerebral mucormycosis, fungal sinusitis, and invasive skull base mucormycosis.
Conclusion:
Rhino-orbital-cerebral mucormycosis is a fulminant fungal infection commonly diagnosed in patients with uncontrolled diabetes. Early diagnosis with radiological and histopathological evaluation is required to identify patients at risk of rhino-orbital-cerebral mucormycosis.
Insights
Central nervous system fungal infections, like rhino-orbital-cerebral mucormycosis, are increasing. Early diagnosis in diabetic patients is crucial for managing this severe condition.
Area of Science:
- Neurology
- Mycology
- Infectious Diseases
Background:
- Central nervous system fungal infections are increasingly prevalent.
- Rhino-orbital-cerebral mucormycosis often affects individuals with uncontrolled diabetes mellitus.
- This case highlights a rare presentation in a bee farmer.
Observation:
- A 47-year-old male with type 2 diabetes presented with severe headache, facial numbness, ptosis, memory loss, and hand numbness.
- Neuroradiological imaging revealed a left temporal ring-enhancing lesion.
- Histopathological evaluation confirmed cerebral mucormycosis, fungal sinusitis, and invasive skull base mucormycosis.
Findings:
- The patient's symptoms and imaging were consistent with a complex fungal infection.
- Surgical resection of the lesion was performed.
- Histopathology confirmed multiple sites of mucormycosis.
Implications:
- Early diagnosis and prompt management are critical for improving outcomes in rhino-orbital-cerebral mucormycosis.
- This case underscores the importance of considering fungal infections in patients with diabetes and neurological symptoms.
- Integrated radiological and histopathological assessment is vital for accurate diagnosis and risk stratification.
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