Abstract

A CASE REPORT ON A RARE CASE OF RHINOCEREBRAL MUCORMYCOSIS IN A FEMALE DIABETIC PATIENT IN A TERTIARY CARE HOSPITAL, KANCHIPURAM

*Dr. M. Anuradha, M. D, Dr. K. MuthuLakshmi

Abstract

Background: Rhinocerebral mucormycosis is a fatal rapidly progressing fungal infection caused by members of order Mucorales such as Rhizopus, Absidia and Mucor. The disease manifestations consist of sinusitis, oedema of eyelids, proptosis, ptosis, ophthalmoplegia, cranial nerve palsy and with the cerebral involvement invariably fatal. Treatment with antifungal agents can only prolong the life expectancy but not curative. In our present case per nasal swab was sent for fungal culture. It was inoculated into SDA. After 24 hours of incubation abundant cottony growth was observed. Microscopically cellophane preparation showed rhizoids, sporangiophore, vesicle,, sporangium and sporangiospores strongly suggesting RhizopusThe case was clinically followed. Clinical history was that of a female patient 50 years old attending diabetic OP with pain in the left side of face 1 week duration, sudden inability to open the left eyelid, pain around eye associated with double vision more on leftside. One episode of dark coloured nasal discharge 1 week ago. MRI scan report showed space occupying lesion. By correlating clinical, MRI scan findings and microbiological report the case was diagnosed as Rhinocerebralmucor mycosis. The prognosis of rhinocerebral mucormycosis is poor. Present case as it has invaded through paranasal sinuses its course is invariably fatal. This emphasizes effective interaction among clinicians and diagnostic team essentially needed for proper early diagnosis of cases.

Keywords: Mucorales, Rhizopus, Ptosis, Ophthalmoplegia,, MRI, Rhinocerebral mucormycosis, LAMP