Case report. Fatal rhinocerebral zygomycosis due to Rhizopus oryzae

Abstract

A case of rhinocerebral zygomycosis due to Rhizopus oryzae, arising after trauma in a 53-year-old diabetic man, is reported. Diagnosis was based on histological and mycological examination. Fragments of the colonies were observed by scanning electron microscopy. This is the first case diagnosed in Tuscany.

A meta‐analysis of survival factors in rhino‐orbital‐cerebral mucormycosis—has anything changed in the past 20 years?

“…In total, 210 case reports were identified from the literature search and reviewed, of which 175 contained sufficient clinical data to be analysed. These were derived from a total of 140 papers (some papers contained multiple case reports) . Larger case series were usually excluded due to a lack of chronological data (refer to Figure for PRISMA flow diagram).…”

Rhinocerebral zygomycosis in a diabetic patient

“…The genus Rhizopus accounts for a large proportion of cases of the order Mucorales, while Rhizopus (oryzae) arrhizus is the main species identified worldwide 2,3 . The most frequent form of infection is rhinocerebral, which manifests in the nasal mucosa and paranasal sinuses and may spread to the orbit through the ethmoid, maxillary sinuses or tear ducts, reaching the brain through the orbital vessels 4 .…”

“…The infection may be gastrointestinal, pulmonary, cardiac, rhinomaxillary, rhinocerebral-orbital or disseminated 4,5 . It is most common in immunocompromised individuals, patients with uncontrolled diabetes mellitus, hematological malignancy, advanced renal disease or with a transplanted kidney 6 .…”

COVID-19-Associated Rhino-Orbital Mucormycosis: Histological and Electron Microscopy Characteristics

“…Another TEM study described the early post-infection localization and germination of spores in the lung epithelium in murine mucormycosis and aspergillosis models [26]. One case report employed SEM to describe the aspect of Rhizopus arrhizus spores collected from a colony grown from a biopsy sample from a patient with rhinoorbital-cerebral mucormycosis [43]. SEM images of spores can be used to distinguish some fungal species (while others have too similar-looking spores), but for reliable identification, a PCR test would be required [44].…”

“…95/2006 on Health Reform, art. 165 and Medical Deontology Code, articles [42][43][44][45]. The harvesting protocol of this study was evaluated and approved by the Ethics Committee Board of Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, no.…”