Rhino-cerebral mucormycosis due to Rhizopus oryzae: A case report

Mucormycosis infections are rare in France, and are caused by fungi of the class Zygomycetes, order Mucorales. The prognosis of these emergent pathologies remains severe. We report a case of a 44-year-old man, who has been admitted to the Emergency Care Unit, for a fly-away acute sinusitis resistant to antibiotic treatment. Biological parameters revealed a diabetic ketoacidosis. On day 2 after admission, ocular dysfunctions happened. An ethmoido-oculo-cerebral lesion was revealed by a cerebral MRI, suggesting a mucormycosis infection. Isolation of Rhizopus orizae was performed by a surgical histologic biopsy. Mucormycosis agents of are ubiquitary. Rhino-cerebral lesions are the most common clinical manifestations. Diabetic ketoacidosis and hematologic malignancies are respectively the two higher risk factors of mucormycosis development. This angioinvasive fungal infection induces more than a 50% rate mortality despite the first surgical-line therapy. To conclude, a global therapeutic care and a complete knowledge of this varied clinical fungi infection must be controlled. The actual incidence of diabetes is increased, thus a mucormycosis infection must be evoked in non-responsive head and neck infections. (C) 2011 Elsevier Masson SAS. All rights reserved.