J Rhinol.  2015 May;22(1):55-58. 10.18787/jr.2015.22.1.55.

Two Cases of Rhinocerebral Mucormycosis

Affiliations
  • 1Department of Otolaryngology-Head & Neck Surgery, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea. d0ramong@hanmail.net

Abstract

Mucormycosis is a rare opportunistic fungal infection. The most common infection site is the paranasal sinuses, although it can also occur in the lungs and skin. The fungus adheres to tissue membranes and forms thrombi, causing ischemia and hemorrhagic necrosis. Rhinocerebralmucormycosiscan occurin the nose, but mightrapidly spread to the orbit and intracranium. Therefore, prompt and aggressive treatment is required. However, because of its low incidence, few reported cases have focused on accompanying disease, proper treatment period, and disease progression. Herein, we report two cases of rhinocerebralmucormycosiswith a brief literature review.

Keyword

Mucormycosis

MeSH Terms

Disease Progression
Fungi
Incidence
Ischemia
Lung
Membranes
Mucormycosis*
Necrosis
Nose
Orbit
Paranasal Sinuses
Skin

Figure

  • Fig. 1. Endoscopic findings in the nasal cavity. A: Right nasal cavity of Case 1. Cavity is filled with many crusts and necrotic tissues, and a mucosal defect is observed. B: Left nasal cavity of Case 2. Cavity is filled with necrotic tissues.

  • Fig. 2. Preoperative PNS CT. A: Coronal view of Case 1. CT shows a septal cartilage defect, and both sinuses are clear. B: Coronal view of Case 2 shows inferior and middle turbinate defect so that larger sized nasal cavity and soft tissue density in the right maxillary sinus.

  • Fig. 3. Magnetic resonance imaging of Case1. A: T1-weighted axial view shows low-signal forehead swelling. B: T2-weighted axial view shows high-sig-nal forehead swelling with loss of fat marrow signal which is consistent with abscess formation.

  • Fig. 4. Histopathological examination of Case 1. A: Fungal hyphae with blunt angles consistent with mucormycosis are observed with acute suppurative inflammation (black arrow) (GMS stain, ×400). B: Fungal hyphae are observed within a necrotic background (black arrow) (H&E stain, ×200).


Reference

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