Korean J Otorhinolaryngol-Head Neck Surg.  2015 Jul;58(7):503-508. 10.3342/kjorl-hns.2015.58.7.503.

Rhino-Orbito-Cerebral Mucormycosis Complicated as Facial Paralysis and Ophthalmoplegia without Rhinologic Manifestation

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea. chollove@hotmail.co.kr

Abstract

Rhinocerebral mucormycosis is a type of opportunistic infections, which can often be lethal in immunocompromised patients. The infection usually occurs in the nose and can spread to adjacent structures. The most typical symptom is facial pain, followed by headache, fever and bloody tinged rhinorrhea. We experienced three cases of rhino-orbito-cerebral mucormycosis, which showed atypical initial presentations. In our cases, patients visited hospital for unilateral ophthlamoplegia and facial palsy without having any nasal symptoms. After evaluating neurologic and ophthalmic problems, they were referred to the Otolaryngology Head and Neck Surgery Department for confirming nasal invasions. Despite using early a parenteral antifungal agent with immediate surgical debridement, patients died due to a residual cerebral lesions and multiple organ failure. In this article, we present the prognosis and management of rhinocerebral mucormycosis patients with atypical symptoms, as well as a review of the published literatures.

Keyword

Facial paralysis; Mucormycosis; Ophthamoplegia

MeSH Terms

Debridement
Facial Pain
Facial Paralysis*
Fever
Head
Headache
Humans
Immunocompromised Host
Mucormycosis*
Multiple Organ Failure
Neck
Nose
Ophthalmoplegia*
Opportunistic Infections
Otolaryngology
Prognosis
Tolnaftate
Tolnaftate
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