Chonnam Med J.
1998 Dec;34(2):183-190.
A Case of Rhinoorbitocerebral Mucormycosis Associated with Diabetic Ketoacidosis
- Affiliations
-
- 1Department of Internal Medicine, Seonam University Medical School.
- 2Department of Internal Medicine, Chonnam National University Medical School, Kwangju, Korea.
- 3Department of Clinical Pathology, Chonnam National University Medical School, Kwangju, Korea.
- 4Department of Pathology, Chonnam National University Medical School, Kwangju, Korea.
Abstract
- Mucormycosis is the common name given to several different disease caused by fungi of the order Mucorales. It is a rare, rapidly progressive and often fatal opportunistic fungal infection, which occurs commonly in patients with uncontrolled diabetes, steroid overuse, bone marrow transplantation, acute leukemia and malnutrition. We report a case of rhinoorbitocerebral mucormycosis confirmed by maxillary sinus mucosal biopsy, which shows characteristic fungal hyphae. The patient was a 48-year-old man, who had diabetes mellitus for 7 years with a one day history of mental confusion, swelling and pain in the right eye. On the admission, blood glucose was < 500mg/dL and arterial blood gas analysis revealed severe metabolic acidois (pH 7.037, HCO3- 3.2 mmol/L). Orbital and paranasal sinus CT revealed right maxillary and ethmoid sinusitis, bony erosion of medial wall of the right orbit, and inflammation of right temporal lobe and right carvernous sinus. After endoscopic removal of necrotic tissue and orbital decompression, systemic intravenous ampho- tericin B (1.0mg/kg/day) was given for 85 days to total dose of 2225 mg. On the 99th hospital day, he was discharged against further treatment and died on 3 months after discharge.
Keyword
MeSH Terms
-
Amphotericin B
Biopsy
Blood Gas Analysis
Blood Glucose
Bone Marrow Transplantation
Decompression
Diabetes Mellitus
Diabetic Ketoacidosis*
Ethmoid Sinus
Ethmoid Sinusitis
Fungi
Humans
Hyphae
Inflammation
Leukemia
Malnutrition
Maxillary Sinus
Middle Aged
Mucorales
Mucormycosis*
Orbit
Temporal Lobe
Amphotericin B
Blood Glucose
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