Rhinocerebral Mucormycosis with Selective Cranial Nerve Palsy / 대한이비인후과학회지

ABSTRACT

Rhinocerebral mucormycosis, a rare opportunistic invasive fungal infection, is known to be fatal and aggressive. It is characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit, and the brain. This disease is most often associated with diabetic ketosis but can be seen with uremic acidisis, leukemia, malnutrition, AIDS, steroid, antimetabolic or antibiotic therapy, severe burn, septicemia, and treatment with immunosuppressive medications. Early clinical recognition of this potentially fatal disease is essential before irreversible changes occur. We report in this study about a 40-year-old man with poorly controlled diabetes mellitus who developed mucormycosis which involved unilateral paranasal sinus, orbit, and selective cranial nerves (especially, hypoglossal nerve). Despite of treatment he died from an abruptly developed acute respiratory distress syndrome that might be caused by mucormycotic hematogenous dissemination 33 days after admission.