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A Case Of Mucormycosis Presenting With Total Ophtalmoplegia And Peripheral Facial Palsy

Year 2012, , 140 - 143, 01.09.2012
https://doi.org/10.5505/sakaryamj.2012.02996

Abstract

Mucormycosis is an acute and often fatal infection caused by a fungus of the Mucorales order of the Zygomycetes class. Mucormycosis are rarely pathogenic in healthy adults, but can cause fatal infections in patients with immunosupression and diabetes mellitus. Seventy-one years old male patient was diagnosed asthma in other center and was treated with oral and intravenous methyl prednisolone without learning diabetic history; applied to our clinic with the complaint of headache and facial pain, diplopia, loss of eye vision, and ptosis. On neurological examination, he presented a mild periorbital edema, left eye ptosis, blindness, total ophthalmoplegia and peripheral facial palsy. Laboratory findings show leucocytosis and hyperglycemia. Magnetic resonance imaging demonstrates progression of infection. On third day, a palatal ulcer was observed on the hard palate. Clinical suspicion of mucormycosis was confirmed by histological staining and culturing of tissue specimens from the palate. Based on these findings, a broad intravenous antibiotic and antimycotic therapy was initiated within 12 h after admission. Surgical debridement was applied twice to clean the cavity. Despite aggressive management, the patient died after 40 days from admission to our clinic. This case was reported to emphasize the mucormycosis which results in high mortality.

References

  • Tugsel Z, Sezer B, Akalin T. Facial swelling and palatal ulceration in a diabetic patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98(6): 630-36.
  • Bhansali A, Bhadada S, Sharma A, Suresh V, Gupta A, Singh P, Chakarbarti A, Dash RJ. Presentation and outcome of rhino- orbital-cerebral mucormycosis in patients with diabetes. Postgrad Med J 2004; 80(949): 670–74.
  • Hadzri MH, Azarisman SM, Fauzi AR, Kahairi A. Invasive rhinocerebral mucormycosis with orbital extension in poorly- controlled diabetes mellitus. Singapore Med J 2009; 50(3):107- 109.
  • Ferguson AD. Rhinocerebral mucormycosis acquired after a short course of prednisone therapy. J Am Osteopath Assoc 2007; 107:491-93.
  • Harril WC, Stewart MG, Lee AG, Cernoch P. Chronic rhinocerebral mucormycosis. Laryngoscope 1996; 106:1292-97.
  • Park SK, Jung H, Kang MS. Localized bilateral paranasal mucormycosis: a case in an immunocompetent patient. Acta Oto

Periferik Yüz Felci ve Total Oftalmoplejiyle Prezente Olan Mukormikozisli Bir Olgu Sunumu

Year 2012, , 140 - 143, 01.09.2012
https://doi.org/10.5505/sakaryamj.2012.02996

Abstract

Mukormikozis Zigomiçes grubunun mukorales cinsi bir fungusun neden olduğu akut başlayan ve sıklıkla öldürücü bir hastalıktır. Mukormikozis enfeksiyonları nadiren sağlıklı bir konağı enfekte eder, ancak diyabetes mellitus ve immünsüpresif altındaki hastalarda fatal enfeksiyonlara yol açabilir. Göz kapağında düşme, görmede azalma, çift görme, yüz ve başağrısı şikayetleriyle kliniğimize başvuran 17 yaşında erkek hastaya, başka bir merkezde astım teşhisi konulmuş ve diyabet öyküsü bilinmeksizin oral ve intravenöz metilprednizolon uygulanmıştı,. Nörolojik muayenesinde ılımlı periorbital ödem, sol gözde ptoz, amaroz, total oftalmopleji ve periferik yüz felci mevcuttu. Laboratuar bulgularında lökositoz ve hiperglisemi dışında özellik yoktu. Magnetik rezonans inceleme ile enfeksiyonun progrese olduğu görüldü. Otuzbirinci günde sert damakta bir palatal ülser tespit edildi. Mukormikozis şüphesiyle damaktan alınan doku örneğinin kültür ve histopatolojik incelemesiyle tanı doğrulanmış oldu. Bu bulgular eşliğinde, yatışının ilk 12 saati içinde acil intravenöz antibiyotik ve antimikotik tedavi başlatıldı. Kaviteyi temizlemek için iki kez cerrahi debritman uygulandı. Bu yoğun tedaviye rağmen hasta kliniğimize yatışının kırkıncı günü ex oldu. Bu olguyla, mukormikozisin yüksek mortaliteyle sonuçlanabilen bir hastalık olduğunu vurgulamak istedik.

References

  • Tugsel Z, Sezer B, Akalin T. Facial swelling and palatal ulceration in a diabetic patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98(6): 630-36.
  • Bhansali A, Bhadada S, Sharma A, Suresh V, Gupta A, Singh P, Chakarbarti A, Dash RJ. Presentation and outcome of rhino- orbital-cerebral mucormycosis in patients with diabetes. Postgrad Med J 2004; 80(949): 670–74.
  • Hadzri MH, Azarisman SM, Fauzi AR, Kahairi A. Invasive rhinocerebral mucormycosis with orbital extension in poorly- controlled diabetes mellitus. Singapore Med J 2009; 50(3):107- 109.
  • Ferguson AD. Rhinocerebral mucormycosis acquired after a short course of prednisone therapy. J Am Osteopath Assoc 2007; 107:491-93.
  • Harril WC, Stewart MG, Lee AG, Cernoch P. Chronic rhinocerebral mucormycosis. Laryngoscope 1996; 106:1292-97.
  • Park SK, Jung H, Kang MS. Localized bilateral paranasal mucormycosis: a case in an immunocompetent patient. Acta Oto
There are 6 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ayfer Ertekin This is me

Recep Aygül This is me

Gökhan Özdemir This is me

Dilcan Kotan This is me

Hızır Ulvi This is me

Publication Date September 1, 2012
Submission Date September 7, 2015
Published in Issue Year 2012

Cite

AMA Ertekin A, Aygül R, Özdemir G, Kotan D, Ulvi H. Periferik Yüz Felci ve Total Oftalmoplejiyle Prezente Olan Mukormikozisli Bir Olgu Sunumu. Sakarya Tıp Dergisi. September 2012;2(3):140-143. doi:10.5505/sakaryamj.2012.02996

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