Rhinocerebral mucormycosis due to Rhizopus oryzae in a diabetic patient: a case report.

Mucormycosis is an opportunistic fulminant fungal infection, which affects nose and paranasal sinuses by direct invasion or through the blood vessels mainly in diabetic and immunocompromised patients. In the present study, a rhino-orbito-cerebral mucormycosis in a 24-year-old female with diabetes mellitus as underlying disease was reported. Computed tomography (CT scan) demonstrated an increase in the soft tissue densities in the left nasal cavity, maxillary and ethmoid sinuses and destruction of the antral wall with soft tissue densities in the pterygopalatine fossa and retromaxillary fissure. In histopathology, wide ribbon-shape non-septate hyphae were seen in tissue sections stained with hematoxylin-eosin (H&E). The etiologic fungus isolated from tissue biopsy on mycological media was identified by the amplification and sequencing of the 5.8S RNA gene and of the adjacent internal transcriber spacer domains, ITS1/ITS4, as Rhizopous oryzae. Recognition of the unique patterns of this high mortality rhinocerebral fungal infection in patients with diabetes is a key to early diagnosis and successful treatment.