A case of progressive rhino-orbital mucormycosis involving the brain via direct extension, retrograde perineural spreading and middle cerebral artery vasculopathy

Abstract

Introduction: Rhino-orbito-cerebral mucormycosis is a progressive angioinvasive fungal disorder which almost always complicates immunocompromised patients. Case presentation: We described a case of fulminant rhino-orbito-cerebral mucormycosis in a 65-year-old woman, who presented with progressive neurological deficits due to involvement of orbital apex and the central nervous system by local invasion of the left inferior frontal lobe, retrograde perineural spreading to the brain stem and middle cerebral arteries thrombosis. Discussion: Early diagnosis is mandatory in managing of this life-threatening disorder. Urgent surgical debridement associated with antifungal agents (amphotericin with posaconazole) is the mainstay of treatment.