Abstract
Background
Rhino-orbital cerebral mucormycosis (ROCM) is a rare infection caused by an invasive
fungus and found predominantly in immunocompromised patients. The presentation of
ROCM ranges from a mild headache, fever, and sinusitis to vision loss, altered mental
status, and facial disfigurement secondary to local tissue invasion. ROCM can cause
significant morbidity and mortality and requires prompt diagnosis with timely evaluation
by surgical and infectious disease specialists. Cases of ROCM have been reported extensively
in internal medicine, infectious disease, and otolaryngology literature. However,
there are very few reports in emergency medicine literature in the United States.
Case Report
A 72-year-old woman presented to the Emergency Department (ED) with altered mental
status, 4 days of left-sided facial numbness and weakness, and sudden facial pain,
swelling, and erythema. Laboratory analysis was consistent with diabetic ketoacidosis.
Noncontrast computed tomography of the head and magnetic resonance imaging of the
brain demonstrated findings indicative of invasive fungal infection of the left sinus
and orbit with extension to the cavernous sinus and surrounding cranial nerves. She
was initiated on broad-spectrum antifungals, but based on the extent of the infection,
was not a surgical candidate. She subsequently transitioned to a comfort-based plan
of care and died 6 days after initial ED presentation.
Keywords
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REFERENCES
- Rhino-orbital-cerebral mucormycosis.Curr Infect Dis Rep. 2012; 14: 423-434
- Global epidemiology of mucormycosis.J Fungi. 2019; 5 (Available at:Accessed December 21, 2022): 26https://doi.org/10.3390/jof5010026
- Rhinocerebral mucormycosis.(Updated 2021 Apr 7)StatPearls (Internet). StatPearls Publishing, Treasure Island, FL2021 (Available at:) (Accessed December 21, 2022)
- A meta-analysis of survival factors rhino-orbital-cerebral mucormycosis–has anything changed in the past 20 years?.Clin Otolaryngol. 2019; 43: 1454-1464
Article info
Publication history
Published online: December 18, 2022
Accepted:
December 13,
2022
Received in revised form:
December 1,
2022
Received:
March 22,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
