Conidiobolomycosis is an uncommon, chronic, localized subcutaneous mycosis primarily affecting rhinofacial region. It is reported mainly from tropical and subtropical countries. The condition is underreported due to the lack of clinical suspicion and usually mismanaged. This rare mycosis is due to the genus Conidiobolus within the order Entomophthorales of class Zygomycetes. Here we present 3 cases of rhinofacial conidiobolomycosis in otherwise healthy adults from different parts of Sri Lanka over 1-year period. All patients had disfiguring subcutaneous lesions in the rhinofacial area. The diagnoses were based on isolation of Conidiobolus coronatus in clinical specimens.

The commonest microbial agents implicated in CSOM was pseudomonas species followed by staphylococci and coliforms. Demographic variables such as gender or age did not seem to affect the disease manifestation significantly, though CSOM was less common among elderly and women.

Rhinocerebral mucormycosis is a life threatening fungal infection occurring in humans, which is caused by the ubiquitous saprophytic fungi of order Mucorales. A timely diagnosis in patients with predisposing factors leading to immunosuppression is of great importance in reducing mortality and morbidity. We describe a patient presenting with typical clinical manifestations of rhinocerebral mucormycosis involving the paranasal sinuses and the orbit. Keywords: Mucormycosis, fungal infection, rhizopus, amphotericin B, surgical debridement Case reportA 39 year old male patient presented to a medical ward with a history of fever, left sided earache with discharge and headache for 1 month; swelling, weakness and numbness of left side of the face for 10 days with drooping and difficulty in moving the left eye for 4 days. He was a noncompliant type II diabetes mellitus patient for 9 years and a heavy alcoholic. A diagnosis of left sided otitis media, mastoiditis and sinusitis was made at another institute. A non-contrast CT scan of petrous-temporal bones and paranasal sinuses done due to the facial symptoms revealed acute sinusitis involving the left frontal, maxillary, sphenoid and bilateral ethmoid sinuses and left sided mastoiditis with otitis media.On examination he was conscious and rational, afebrile and had no signs of meningism but had complete ptosis of the left eye, proptosis and lid oedema, left sided complete ophthalmoplegia and V and VII cranial nerve palsies.On admission his capillary blood sugar was 293mg/dl and WBC was 8600/mm 3 (DC-N 53.8%, L 36.6%). Oral hypoglycaemics, nasal decongestants, antihistamines and empirical antibiotics were started. An urgent referral was made to the ENT surgery team as mucormycosis was high in the differential diagnoses. A rigid nasal endoscopy (RNE) revealed fungal debris and pus in the left maxillary region and polypoidal lesions lateral to the maxillary turbinate. A biopsy of the latter was sent for histology. The patient was transferred to the ENT ward. Histology report suggested a fungal infection, possibly mucormycosis. Three days later, another RNE and

There was no significant association between presbyacusis and other demographic factors such as gender, education level and marital status. A significant proportion of the participants had been widowed and that fact, too, can reduce their quality of life.

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