Rhino-Orbito-Cerebral Mucormycosis: Clinical Presentation and Outcome

Results: Age range was 18 to 60 years. Predisposing factor was Diabetes mellitus in all patients, with ketoacidosis in two and renal failure in one. Dark necrotic nasal crusts in four, facial pain in seven, ocular involvement including proptosis in seven, ophthalmoplegia in five, necrosis of palate in one, CNS involvement in three and hemiplegia in two. All patients were treated with intravenous Amphotericin-B, followed by surgical debridement. Various surgical interventions were used, including ethmoidectomy, sphenoidectomy, partial or radical maxillectomy etc. Six patients died due to various causes, one lost to follow up, three were alive and disease free (1 to 5 years). Conclusion : Rhino-orbito-cerebral mucormycosis in present case series was mostly seen in middle aged diabetics. ENT, ocular and CNS features were common. As most of the cases presented in advanced stages, the disease had high mortality. Amphotericin-B and thorough surgical debridement are the mainstay of the treatment; with control of the predisposing factors.