Sinonasal Mucormycosis in a Diabetic - Case Report

ABSTRACT

Background: Mucormycosis is one of the rapidly progressing and lethal form of fungal infection which involves the nose and paranasal sinuses of the head and the neck regions. It manifests as rhinocerebral, sinonasal, pulmonary, gastrointestinal, cutaneous or disseminated form. The underlying conditions can influence clinical presentation and often delay diagnosis, with resultant poor outcomes. Objective: To present and discuss the case of a diabetic patient with sinonasal mucormycosis presented with facial pain and discolouration of right side of nose and face due to mucormycosis. Case report A 23 years old female patient presented to emergency with uncontrolled blood sugars, pain and swelling over right side of face and blackish discolouration of right side of nose. On examination, there was bluish black discolouration of skin over right side of dorsum of nose and right ala of nose and right nasal vestibule. Sinus CT scan showed features suggestive of fungal sinusitis. Mucormycosis was suspected, confirmed with biopsy and surgical debridement and medial maxillectomy done. Intravenous amphotericin B was administered for 21 days. The patient was followed up regularly, the disease appearing to be resolved. Conclusion: Mucormycosis is a rapidly progressive fatal infection mostly reported in immune-compromised individuals. Emergency multidisciplinary treatment for control of blood sugars, surgical debridement and effective antifungal medications gives better clinical outcome.