Rhino-Orbital Cerebral Mucormycosis: A Fatal Evolution

Abstract

Rhino-orbital cerebral mucormycosis is a rare and serious fungal infection caused by fungi of the Mucorales order, most commonly by the species Rhizopus oryzae. It occurs generally in an immunocompromised host, and the contamination of healthy subjects remains exceptional. The clinical presentation is not specific. The diagnosis of rhino-orbital cerebral mucormycosis is difficult based on a range of clinical, microbiological, and radiological arguments. Imaging studies may include CT/MRI of the orbit, brain, and sinuses and show signs of aggressiveness, intracranial complications, and evolution under treatment. The standard treatment is antifungal therapy and necrosectomy. We report a case of a 30-year-old patient admitted to intensive care for the management of postpartum hemorrhage complicating severe preeclampsia who presented with rhinocerebral mucormycosis with left orbital extension. Adequate therapeutic management in the intensive care unit was provided; however, the patient died within seven days of septic shock with multiorgan failure. The mortality is determined by the correction of risk factors, the timing of initiation of the antifungal therapy, and surgical debridement.

Interdisziplinäre Therapie der Erkrankungen der Orbita

“…Therapeutisch steht eine rasche chirurgische Intervention im Vordergrund, wenn es der Allgemeinzustand des Patienten zulässt. Daneben ist die systemische Gabe von Antimykotika indiziert [32,37,38]. Die Mortalitätsrate beträgt trotz maximaler chirurgischer und medikamentöser Therapie über 30 % [36,39].…”