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Rhinocerebral Mucormycosis with Extensive Cranial Nerve Palsies in a Diabetic Patient

K V P Munasinghe1, F H D S Silva2

  • 1General Medicine, Colombo South Teaching Hospital Kalubowila, Colombo, LKA.

Cureus
|January 15, 2024
PubMed

Insights

Rhinocerebral mucormycosis, a fungal infection, can affect cranial nerves. This case highlights rare facial nerve involvement in a diabetic patient, emphasizing early diagnosis and treatment.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Ophthalmology

Background:

  • Mucormycosis is a severe opportunistic fungal infection.
  • Rhinocerebral mucormycosis commonly involves sinuses and orbits.
  • Cranial nerve involvement, particularly the seventh (facial) nerve, is infrequent.

Observation:

  • A 70-year-old female with poorly controlled diabetes mellitus presented with rhinocerebral mucormycosis.
  • The patient exhibited multiple cranial nerve deficits.
  • Facial nerve (seventh cranial nerve) palsy was a notable feature.

Findings:

  • Histopathological confirmation of fungal elements is crucial, as fungal cultures may have low diagnostic yield.
  • Radiological evidence of sinus destruction aids diagnosis.
  • The case demonstrates rare multiple cranial nerve involvement, including the facial nerve.

Implications:

  • Early detection and prompt multimodal treatment are essential for managing mucormycosis.
  • Recognizing facial nerve involvement is critical for preventing severe outcomes.
  • This case underscores the importance of considering mucormycosis in diabetic patients with neurological deficits.
Keywords:
amphotericincranial nerve palsydiabetesimmunocompromisedrhinocerebral mucormycosissinusitis

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