Rhino-Orbital-Cerebral Mucormycosis Causing Orbital Apex Syndrome and Blindness

• Main Authors: Musab Abdulaziz Alsubaie, Saeed Abdullah Alghamdi, Saif Abdulghani Alghamdi, Ahmed Mohammed Abdelaal, Mohamed Bakhit Satti
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2018-04-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: eye infection; orbit; orbit evisceration
• Online Access: https://jcdr.net/articles/PDF/11389/31859_F(SL)_PF1(EK_SL)_PFA(EK_SL)_PB(EK_SL)_PN(SL).pdf

Mucormycosis is a potentially fatal fungal infection caused by a group of molds called mucormycetes. Rhino-Orbital-Cerebral Mucormycosis (ROCM) represents nearly half of all cases. This is the case of a 46-year-old female recently diagnosed with leukaemia and was started on chemotherapy. After initiating chemotherapy, she complained of headache, blurring of vision in the right eye and nasal discharge. Examinations revealed orbital apex syndrome. MRI disclosed an inflammation affecting the right orbit, ethmoid sinus and the frontal lobe. Ethmoidectomy was performed and biopsies confirmed mucormycosis. After that, symptoms persisted and complete loss of vision in her right eye occurred. Right orbital exenteration was required. The response was noticed over the subsequent weeks until she became asymptomatic. Five weeks after initially being diagnosed with leukaemia, she entered remission and was discharged on oral itraconazole and oral retinoic acid. Later, she remained in complete remission. In conclusion, early suspicion and diagnosis especially in immunocompromised patients with early aggressive treatment can be life saving.