Onyi Stella, Shin Joon, Umeh Chukwuemeka A, Sabat Shyamsunder, Albayram Mehmet S
Radiology, University of Florida College of Medicine, Gainesville, USA.
Internal Medicine, Hemet Global Medical Center, Hemet, USA.
Cureus. 2022 Mar 11;14(3):e23068. doi: 10.7759/cureus.23068. eCollection 2022 Mar.
Mucormycosis is a life-threatening invasive fungal infection usually seen in immunocompromised patients and patients with poorly controlled diabetes mellitus with or without diabetic ketoacidosis. We present a rhino-orbito-cerebral mucormycosis (ROCM) case in a coronavirus disease 2019 (COVID-19) patient complicated by the optic nerve and optic tract ischemia with ischemic neuropathy. Both CT and MRI played an essential role in diagnosing ROCM and the accompanying complications in our patient. CT showed sinonasal sinusitis and MRI showed the sinusitis and its progression to ROCM. MRI also showed necrosis involving the bilateral orbits, basal ganglia, thalamus, internal capsule, hypothalamus, optic chiasm, optic nerves, olfactory bulbs, and skull base. ROCM associated with optic nerve ischemia is a rare but life-threatening complication of COVID-19, especially in patients with underlying diabetes and/or those treated with corticosteroids. Physicians should be aware of this complication as early diagnosis may improve the chances of survival in such patients.
毛霉病是一种危及生命的侵袭性真菌感染，通常见于免疫功能低下的患者以及糖尿病控制不佳且伴有或不伴有糖尿病酮症酸中毒的患者。我们报告了1例2019冠状病毒病（COVID-19）患者发生的鼻眶脑毛霉病（ROCM），该患者并发视神经和视束缺血以及缺血性神经病变。CT和MRI在诊断我们患者的ROCM及其伴随并发症方面均发挥了重要作用。CT显示鼻窦炎症，MRI显示了鼻窦炎症及其进展为ROCM的情况。MRI还显示双侧眼眶、基底神经节、丘脑、内囊、下丘脑、视交叉、视神经、嗅球和颅底出现坏死。与视神经缺血相关的ROCM是COVID-19一种罕见但危及生命的并发症，尤其是在患有基础糖尿病和/或接受皮质类固醇治疗的患者中。医生应意识到这种并发症，因为早期诊断可能会提高此类患者的生存几率。
