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A Case of Rhinocerebral Mucormycosis Caused by Mucor Species

Sung Jun Kim,Jae Young Lim,Ho Sun Jang,Chang Keun Oh,Kyung Sool Kwon
Epub 2016 February 22

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Abstract



Mucormycosis refers to infections caused by the order Mucorales of the class Zygomycetes. They are acute, rapidly developing, often fatal, opportunistic infections of immunocompromised patient. We report a case of rhinocerebral mucormycosis in a 73-year-old man with a 20-year history of poorly controlled diabetes mellitus. He had black necrotic ulcers on the hard palate, left blepharoptosis, left visual loss, left facial palsy and left hemiparesis. Brain and sino-orbital MRI scan showed protrusion of left eyeball, sinusitis on the both maxillary and ethmoid sinus and left middle cerebral artery infarction. Swab of black necrotic ulcer on the hard palate yielded large fungal hyphae on KOH preparation and

inoculation of necrotic tissue on Sabouraud dextrose agar revealed a rapid growth of white to gray cottony colonies that soon turned gray to dark brown. Slide culture showed globose sporangia and no rhizoid or apophysis. These morphologic characteristics were those of the Mucor species. Histopathologic examination of the palatal lesion showed large, non-septated fungal hyphae in the dermis. The patient was treated with amphotericin B 50 mg/day for 45 days but died 114 days after admission.



Keywords


Rhinocerebral mucormycosis Mucor species Diabetes mellitus




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