Mucormycosis presenting with painful ophthalmoplegia

Mucormycosis is a rare fungal infection that can involve the sino-orbito-cerebral region. Sino-orbito-cerebral mucormycosis is most common in patients who are immunocompromised or have diabetes mellitus, severe malnutrition or burns. This condition can be fatal if it is not diagnosed early and treat...

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Bibliographic Details
Published inActa neurologica Belgica Vol. 105; no. 4; p. 201
Main Authors Karakurum, B, Karatas, M, Cagici, A C, Uncu, H, Yildirim, T, Hurcan, C, Karaca, S, Kizilkilic, E, Tan, M
Format Journal Article
LanguageEnglish
Published Italy 01.12.2005
Subjects
Aged
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Cavernous Sinus - microbiology
Central Nervous System Fungal Infections - drug therapy
Central Nervous System Fungal Infections - microbiology
Chronic Disease
Cranial Nerve Diseases - drug therapy
Cranial Nerve Diseases - microbiology
Debridement
Diabetes Complications
Female
Humans
Leukemia - complications
Male
Middle Aged
Mucormycosis - physiopathology
Mucormycosis - therapy
Ophthalmoplegia - microbiology
Orbital Diseases - microbiology
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Summary:Mucormycosis is a rare fungal infection that can involve the sino-orbito-cerebral region. Sino-orbito-cerebral mucormycosis is most common in patients who are immunocompromised or have diabetes mellitus, severe malnutrition or burns. This condition can be fatal if it is not diagnosed early and treated aggressively. This article presents 4 cases of mucormycosis, including 2 with orbital apex syndrome, 1 with cavernous sinus syndrome, and 1 with multiple cranial nerve involvement. All of the patients were presented with painful ophthalmoplegia. The predisposing factors for mucormycosis included diabetes mellitus (three patients) and chronic leukemia (one patient). In all cases, mucormycosis was diagnosed by examining endoscopic sinus drainage material and was treated with surgical debridement and amphotericin B. Two patients with central nervous system involvement died. The others have survived, but still exhibiting various neurologic abnormalities after aggressive treatment. Patients with mucormycosis rarely present with orbital apex syndrome. The possibility of mucormycosis should be investigated in any patient with painful ophthalmoplegia, and prompt otorhinolaryngologic examination is recommended to ensure rapid diagnosis and treatment.
ISSN:0300-9009