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Cerebritis, optic ischemia, and cavernous sinus thrombosis arising from sinonasal mucormycosis

Eliseo Picchi1,2, Noemi Pucci1,3, Alessia Amatruda1

  • 1Diagnostic Imaging Unit, University Hospital of Rome "Tor Vergata", Viale Oxford 81 00133, Rome, Italy.

Radiology Case Reports
|July 10, 2024
PubMed

Insights

Sinonasal infections can lead to severe brain and eye issues in immunocompromised patients. This case highlights a fatal outcome of maxillo-spheno-ethmoidal rhinosinusitis following stem cell transplantation.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Neurology

Background:

  • Sinonasal infections pose significant risks, particularly fatal brain and ocular complications in immunocompromised individuals.
  • Allogeneic hematopoietic stem cell transplantation (HSCT) is a critical procedure for hematologic malignancies, often leaving patients susceptible to opportunistic infections.

Observation:

  • A 35-year-old female, post-HSCT for acute myeloid leukemia, presented with severe maxillo-spheno-ethmoidal rhinosinusitis.
  • The rhinosinusitis rapidly progressed to life-threatening complications.

Findings:

  • The patient developed cavernous sinus thrombosis, orbital cellulitis, and optic ischemia.
  • Cerebritis was also identified, indicating extensive central nervous system involvement.

Implications:

  • This case underscores the critical need for vigilant monitoring and prompt management of sinonasal infections in HSCT recipients.
  • Aggressive treatment strategies are essential to prevent devastating neurological and ophthalmological sequelae.
  • Early recognition and intervention can potentially improve outcomes in this vulnerable patient population.
Keywords:
Cavernous sinus thrombosisCerebritisMRIOptic ischemiaOrbital cellulitisSinonasal mucormycosis

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