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Orbitofacial mucormycosis with unusual pathological features.

D M Albert, R L Lesser, R C Cykiert

    The British Journal of Ophthalmology
    |October 1, 1979
    PubMed
    Summary
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    A patient with diabetes and leukemia developed a fatal Rhizopus oryzae infection. Post-mortem analysis revealed fungal hyphae and unusual calcium salt crystals in the degenerated eye.

    Area of Science:

    • Medical Mycology
    • Ophthalmology
    • Pathology

    Background:

    • Orbital mucormycosis is a rare, aggressive fungal infection.
    • Patients with diabetes and hematologic malignancies are at high risk.
    • Rhizopus oryzae is a common cause of mucormycosis.

    Observation:

    • A 52-year-old man with diabetes and acute stem cell leukemia presented with orbitofacial mucormycosis.
    • Despite aggressive treatment with amphotericin B and antibiotics, the infection was fatal.
    • Post-mortem examination revealed fungal hyphae in the eye, orbit, and lungs.

    Findings:

    • Histochemical staining and x-ray diffraction identified birefringent crystals in the degenerated eye.
    • These crystals were identified as calcium salts of fatty acids.

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  • The salts were liberated from necrotic orbital adipose tissue.
  • Implications:

    • This case highlights the aggressive nature of Rhizopus oryzae infections in immunocompromised patients.
    • The presence of calcium salt crystals is an unusual finding in orbital mucormycosis.
    • Further research may elucidate the role of these crystals in disease pathogenesis or diagnosis.