Mehdi Zainab, Bhardwaj Nidhi, Aggarwal Jyoti, Kaur Narinder, Singh Brijdeep
Department of General Medicine, Government Medical College and Hospital, Sector -32 Chandigarh, India.
Department of Radio diagnosis, Government Medical College and Hospital, Sector -32 Chandigarh, India.
Arch Acad Emerg Med. 2021 Jul 28;9(1):e54. doi: 10.22037/aaem.v9i1.1305. eCollection 2021.
Mucormycosis is an expeditious invasion of a fungus of angioinvasive nature, predominant in immunocompromised individuals, often leading to organ malfunction and loss. Facial nerve involvement and total ophthalmoplegia are its rare presentations. Early detection and treatment can alter natural disease course and prevent potential catastrophic outcomes in diabetic patients. Facial nerve palsy is mostly attributed to peripheral neuropathy in patients with advanced diabetes mellitus. It rarely raises alarm about an invasive fungal infection. Here, we report the case of a 38-year-old male with type 2 diabetes mellitus, who presented to us with left lower motor neuron type facial palsy and left-sided total ophthalmoplegia due to invasive rhino-orbito-cerebral mucormycosis (ROCM). Despite aggressive measures, including antifungal therapy and repeated endoscopic debridement, he subsequently developed central retinal artery occlusion (CRAO) and underwent left eye exenteration.
毛霉菌病是一种具有血管侵袭性的真菌的快速侵袭，在免疫功能低下的个体中占主导地位，常导致器官功能障碍和丧失。面神经受累和完全性眼肌麻痹是其罕见表现。早期发现和治疗可改变自然病程，预防糖尿病患者潜在的灾难性后果。面神经麻痹在晚期糖尿病患者中大多归因于周围神经病变。它很少引发对侵袭性真菌感染的警惕。在此，我们报告一例38岁2型糖尿病男性患者，因侵袭性鼻眶脑毛霉菌病（ROCM）出现左下肢运动神经元型面神经麻痹和左侧完全性眼肌麻痹。尽管采取了积极措施，包括抗真菌治疗和反复内镜清创，他随后仍发生了视网膜中央动脉阻塞（CRAO）并接受了左眼眼球摘除术。
