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Rhino-cerebral Mucormycosis Presenting with Multiple Cranial Nerve Palsy and Cerebral Infarcts in a Patient with Uncontrolled Diabetes Mellitus

Krishnendu Choudhury, Assistant Professor, Department of Neurology and medicine, Jagannath Gupta Institute of Medical Science, Kolkata 700137, India. , Krishnendu Choudhury1 , Koushik Ray2 , Shibendu Ghosh3 , Subhadeep Basu4 , Suprotim Ghosh5

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Indian Journal of Communicable Diseases 7(2):p 49-53, July – December 2021. | DOI: http://dx.doi.org/10.21088/ijcd.2395.6631.7221.6

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Krishnendu Choudhury; Koushik Ray; Shibendu Ghosh; et al. Rhino-cerebral Mucormycosis Presenting with Multiple Cranial Nerve Palsy and Cerebral Infarcts in a Patient with Uncontrolled Diabetes Mellitus, Indian J Comm Dis. 2021;7(2):49–53.
 

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Abstract

Multiple cranial nerve palsy is a syndrome resulting from damage to 2 or more cranial nerves, usually caused by granulomatous inflammation or an infectious process in the superior orbital fissure or lateral wall of cavernous sinus, or retrosphenoid space with involvement of cranial nerves 2, 3, 4, 5, or 6 in combination. Mucormycosis is a potentially lethal opportunistic fungal infection occurring in immunocompromised person. We depict a patient with uncontrolled diabetes mellitus complicated by opportunistic fungal infection in the nose, palate and paranasal sinus progressively invading the cranial nerves 2,3,4,5 - sensory (oph and max), 6 and also the 7 ipsilaterally. The patient also had multiple embolic infarcts of brain with involvement of intracranial ICA territory. Mucormycosis is a serious opportunistic fungal sepsis of the soft tissue around face and mouth, including nose and paranasal sinus in immunocompromised person progressing rapidly to involve multiple cranial nerves and the cerebral vasculature. Risk factors associated with such infection are uncontrolled diabetes mellitus, hyperlipidemia and atherosclerosis. Early suspicion and diagnosis is mandatory to treat this dreadful infection and patient survival. Keywords: Mucorales; Fungal sepsis; Cranial neuropathy; Embolic infarcts; Diabetes mellitus.

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Krishnendu Choudhury; Koushik Ray; Shibendu Ghosh; et al. Rhino-cerebral Mucormycosis Presenting with Multiple Cranial Nerve Palsy and Cerebral Infarcts in a Patient with Uncontrolled Diabetes Mellitus, Indian J Comm Dis. 2021;7(2):49–53.
 

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DOI: http://dx.doi.org/10.21088/ijcd.2395.6631.7221.6

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