Rhino-orbital mucormycosis in an immunocompetent non- COVID19 patient - a case report and review of literature
Keywords:
Mucormycosis, Rhino-orbital mucormycosis, invasive fungal rhinosinusitis, orbital cellulitis, immunocompetent hostsAbstract
Purpose: To report the lethal case of a 57-year-old male non-diabetic patient with Rhino-orbital mucormycosis.
Methods : A case report of a 57-year-old male non-diabetic patient with dental caries developed invasive fungal rhinosinusitis with bilateral orbital cellulitis.
We reviewed the English articles published in Pubmed between 2000 and 2022 and found 34 cases of Rhino-orbital-cerebral Mucormycosis in immunocompetent patients.
Results : Case 57-year-old male non-diabetic patient presented with blurred vision for one day. Histopathology examination of the biopsy specimen revealed the presence of medium to large board-wide fungal hyphae with necrotic tissue. The diagnosis was acute invasive fungal rhinosinusitis with bilateral orbital cellulitis, suspected Mucormycosis. Accordingly, the patient underwent bilateral orbital exenteration and endoscopic sinus debridement on the fifth day after admission. The Eschar was found at the orbital wall. The intravenous antibiotics were Meropenem with Liposomal Amphotericin B. Then, he had a subarachnoid haemorrhage and died on the twelfth day after admission.
From the previous studies, they consisted of 14 male and 21 female patients aged between 16 and 74. All the patients were non-COVID patients. The number of surviving patients is 18 ( 54%).
Conclusion: Mucormycosis is a rare infection in immunocompetent hosts. The leading fatality causes were cerebral mucormycosis. Most patients with good outcomes got infected with Apophysomyces elegans, similar to the previous study.
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