Rhino-orbital-cerebral mucormycosis: a review

Abstract

Rhino-orbital-cerebral mucormycosis (ROCM) is an acute, often fatal, fungal infection caused by members of the class Zygomycetes and the order Mucorales. The genus Rhizopus accounts for most cases of ROCM. The disease is characterized by fungal hyphal invasion of blood vessels resulting in thrombosis and infarction of the nasal, paranasal sinus, orbital, and cerebral tissues. The most commonly associated condition is diabetes mellitus; other associated conditions include immunocompromised states, renal disease, deferoxamine use, and acidotic states. Common clinical findings include rhinitis, periorbital and facial swelling, facial and mucosal necrosis, ophthalmoplegia, multiple cranial nerve palsies, facial pain, and headache. Definitive diagnosis is made by demonstration of fungal hyphae in tissue specimens. The mainstay of treatment is aggressive surgical debridement of infected tissue and administration of amphotericin B. ROCM has a mortality rate of 40-50%; 70% of survivors are left with residual defects. Early diagnosis and treatment are imperative in the successful management of patients afflicted with this devastating sight- and life-threatening disease.

Successful treatment of mucormycosis in a renal allograft recipient

“…Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt e-mail: ogheith@yahoo.com allograft and five extrarenal) were reported in English literature [2][3][4][5][6][7][8][9][10][11]. In all the 11 cases, the prognosis was poor and the story ended with either death of the patient or removal of the graft.…”

“…The prognosis of rhino-cerebral form is poor, with an overall mortality of up to 50% and residual defects in 70% of survivors [3]. Diagnosis requires the demonstration of broad, non-septated, right-angle branching fungal hyphae in the biopsy specimen.…”

A Case Report of Mucormycosis of Faciotemporal Region Mimicking as Bacterial Necrotizing Fasciitis

“…13,14 Tissue hypoxia and acidosis can be reduced to some extent by the use of hyperbaric oxygen therapy but the efficacy of this mode of treatment in such cases is still debatable. 5,15 In spite of aggressive management of this condition with extensive debridement and administration of drugs with multiple known toxic effects the mortality rate of mucormycosis remains between 30 and 69%. 15 A disseminated infection of mucormycosis has a fatality rate of over 90%.…”

“…5,15 In spite of aggressive management of this condition with extensive debridement and administration of drugs with multiple known toxic effects the mortality rate of mucormycosis remains between 30 and 69%. 15 A disseminated infection of mucormycosis has a fatality rate of over 90%. 16 It is recommended that all patients, especially the elderly, should be thoroughly evaluated for the presence of comorbidities and once different factors affecting host defenses are detected, prompt and aggressive management options should be employed.…”

Lessons to be learned from a complicated case of rhino-cerebral mucormycosis in a renal allograft recipient

“…The prognosis of the rhino-cerebral form is poor, with an overall mortality of up to 40-50% [6, 71 and residual defects in 70% of survivors [7]. In transplant recipients, the diagnosis of this rare opportunistic infection can be extremely difficult, in particular due to the antiinflammatory effect of steroids included in most immunosuppressive regimens, obscuring some of the typical signs of infection.…”