Rhino-Orbital Cerebral Mucormycosis in a Healthy Female Child: Case Report

Abstract

Mucormycosis is a potentially fatal condition with a high mortality rate, particularly when there is extra nasal involvement, and it is rare for patients with fungal brain disease to survive. It mostly affects patients who are metabolically or immunologically compromised, which constitutes one of the three classical stages of the progression of Rhino-Orbito-Cerebral Mucormycosis (ROCM). Stage I: infection of the nasal mucosa and paranasal sinuses; Stage II: orbital involvement; Stage III: cerebral involvement.Here, we report a case of rhino-orbital cerebral mucormycosis in a 14-year-old girl with no known risk factor who presented with periorbital edema, right eye proptosis, fever, and extreme facial pain, which progressively worsened to confusion and left leg weakness in 3 days after admission. The final diagnosis was rhino-orbital-cerebral mucormycosis. The infection was successfully treated using liposomal amphotericin and surgical debridement to remove infected orbital tissue. Mucormycosis is a potentially fatal disease that necessitates prompt diagnosis and treatment. Children are rarely infected with mucormycosis. The majority of studies show that people are typically between 40 and 50 years old. ROCM is typically diagnosed using clinical symptoms and histopathologic evaluation; however, imaging is critical in determining the presence of intracranial lesions. The standard treatment for ROCM is amphotericin B at a recommended dose of 1.0–1.5 mg/kg/day for weeks or months, depending on the clinical response and severity of adverse drug reactions, particularly nephrotoxicity.Rhino-orbital cerebral mucormycosis in a healthy female child is uncommon; early diagnosis and prompt treatment with Amphotericin B should be necessary. Devastating consequences will result from a delayed diagnosis.

Keywords:

• mucormycosis
• orbital cellulitis
• liposomal amphotericin B
• cerebral involvement

Ethical Approval

We obtained written informed consent from the child’s parents for publication of this case report and the accompanying images.

Author Contributions

Each author contributed significantly to the work reported, whether it was through conception, study design, execution, data acquisition, analysis, and interpretation, or in all of these areas; they all contributed to draft, revise, or critically review the article; they approved the final version that was published; they all agreed on the journal to which the article was submitted; and they all agreed to take responsibility for the work in its entirety.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

No funding for this research.