Rhinocerebral mucormycosis in a diabetes type 2 patient: A fatal case report from northern Tanzania

Abstract

Mucormycosis is an acute and aggressive fungal infection usually, but not exclusively, occurring in immunocompromised individuals. Lack of knowledge and awareness in developing countries hinders timely management. This case highlights the importance of a prompt index of suspicion for the timely and aggressive intervention of mucormycosis to the Tanzanian community. We report a case of fatal rhino-orbital-cerebral mucormycosis in a diabetic patient presenting at a tertiary hospital in the Kilimanjaro region, Tanzania. Nasal deformity, proptosis, chemosis and left-sided hemiplegia were evident on physical examination. Nasoendoscopy revealed extensive necrosis of the nasal septum, inferior turbinate and involvement of the frontal recess. Computed tomography and magnetic resonance imaging of the paranasal sinuses and head revealed necrosis and ischemic changes due to fungal invasion. The patient deceased due to intracranial complications of advanced fungal invasion. Late presentation and unacquainted with mucormycosis our patient had an unfavourable outcome. Early diagnosis, extensive surgical debridement and a multidisciplinary approach to treatment are of the essence in favour of a better prognosis.