Diagnostic Utility of Polymerase Chain Reaction for Paraffin-embedded Sinus Specimens for Rhinocerebral Mucormycosis Complicated by Internal Carotid Artery Thrombosis and Cerebral Infarction

• Published in: Internal Medicine Vol. 60; no. 16; pp. 2683 - 2686
• Main Authors: Maeda, Yukiko, Toda, Kunio, Toi, Sono, Yano, Tetsundo, Iijima, Mutsumi, Shimizu, Yuko, Nagashima, Yoji, Itakura, Yasutomo, Iguchi, Shigekazu, Kikuchi, Ken, Shibuya, Kazutoshi, Nonaka, Manabu, Kitagawa, Kazuo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.08.2021; Japan Science and Technology Agency
• Subjects: Carotid artery; Case Report; Cerebral infarction; cerebral ischemia; Cerebrospinal fluid; Diagnosis; Etiology; formalin-fixed paraffin-embedded specimens; Internal medicine; Mucormycosis; Paraffin; PCR; Polymerase chain reaction; sinusitis; Thrombosis; sinusitis; formalin-fixed paraffin-embedded specimens; mucormycosis; cerebral ischemia; PCR
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.6809-20

We herein report a 73-year-old man who experienced cerebral infarction caused by infection with a Mucromycocetes species. A delay in anti-fungal treatment might result in a lethal clinical outcome. We were unable to establish an accurate diagnosis based on histological findings and cerebrospinal fluid culture. Therefore, we performed polymerase chain reaction (PCR) using paraffin-embedded specimens, and based on the findings, successfully started administering anti-fungal treatment. We suggest that PCR using sinus specimens be applied when mucormycosis is suspected as an etiology of cerebral infarction and a confirmative diagnosis cannot be established based on the results of pathological examinations or cerebrospinal fluid culture.