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Rhino-orbital mucormycosis in a patient with no susceptibility following P.vivax malaria infection-a case report.
Prasad, Sonali; Gaur, Aman; Mehta, Anuj; Kaushal, Nimisha.
  • Prasad S; Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India. sonalipd92@gmail.com.
  • Gaur A; , New Delhi, India. sonalipd92@gmail.com.
  • Mehta A; Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India.
  • Kaushal N; Department of Ophthalmology, Vardhman Mahavir Medical College and Safdarjung Hospital, Near AIIMS, Ansari Nagar West, 110029, Delhi, India.
BMC Ophthalmol ; 22(1): 389, 2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-2053876
ABSTRACT

BACKGROUND:

Mucormycosis is a potentially lethal, angioinvasive fungal infection caused by the Mucoracea family comprising Mucor, Rhizopus, and Absidia species. It is commonly associated with uncontrolled diabetes mellitus, the use of corticosteroids, immunosuppressive drugs, and Covid-19 infection. The occurrence of mucormycosis in an immunocompetent patient is rare. Also, only a few case reports have been published where patients developed mucormycosis with associated malarial infection. CASE PRESENTATION A young female presented with a 3-weeks history of painful swelling and outward protrusion of the right eye with complete loss of vision. She had a history of P.vivax malaria two weeks before her ocular symptoms. On ocular examination, there was proptosis and total ophthalmoplegia with loss of corneal sensations in the right eye. Hematological examination revealed normocytic normochromic anemia and thrombocytopenia. MRI was suggestive of right-sided pansinusitis and orbital cellulitis with right superior ophthalmic vein thrombosis and bulky cavernous sinus. Nasal biopsy was negative for fungal culture. An emergency surgical debridement of all the sinuses was done with right orbital exenteration. Histopathology confirmed the diagnosis of mucormycosis and the patient improved post-operatively on systemic antifungals.

CONCLUSION:

Such an association of mucormycosis with malaria infection is rarely reported in the literature and is hypothesized to be a result of immunosuppression caused by malaria. Also, emphasis is laid upon having a high index of suspicion for fungal infection in the setting of pansinusitis even if the risk factors are absent. We hereby report a case of rhino-orbital mucormycosis following P.vivax malaria in a 20-year-old female with anemia and thrombocytopenia.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Thrombocytopenia / Eye Infections, Fungal / Malaria, Vivax / Orbital Cellulitis / COVID-19 / Mucormycosis Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Young adult Language: English Journal: BMC Ophthalmol Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: S12886-022-02611-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / Thrombocytopenia / Eye Infections, Fungal / Malaria, Vivax / Orbital Cellulitis / COVID-19 / Mucormycosis Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Young adult Language: English Journal: BMC Ophthalmol Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: S12886-022-02611-8