Rhinocerebral Mucormycosis in a Patient with Type 1 Diabetes Mellitus: Case Report

ABSTRACT

Background: Rhinocerebral mucormycosis is one of the severe forms of infections in persons with diabetes mellitus. Its occurrence is rare and is reported little in our environ- ment. We report a case of rhinocerebral mucormycosis in a patient with type 1 diabetes mellitus (DM) with the aim of drawing the attention of physicians to its existence in our nvironment and the need for aggressive management. Method: The case notes of a patient with type 1 DM presenting with features of rhinocerebral mucormycosis and the rele- vant literature of the subject was reviewed. Result: An eighteen-year old senior secondary school man with a one-year history of type 1 DM was admitted to the male medical ard of Aminu Kano Teaching Hospital (AKTH) with features of diabetic ketoacidosis (DKA); facial rashes involving the medial canthus of the right eye extending to the right para- nasal area and right nostril. The facial rashes which started initially as blisters later progressed to form ulcers with necroses. There was progressive deterioration in level of consciousness with a right hemiparesis. Magnetic resonance imaging (MRI) revealed multiple brain abscesses with dilatation and engorgement of the sphenoidal and maxillary sinuses. He was managed with broad-spectrum antibiotics; antifungals and wound debridement. He continued to deteriorate and died seven weeks later. Conlusion Rhinocere- bral mucormycosis though rare; does occur especially in the setting of DM and requires an aggressive and a multidisciplinary approach to management