Mucormycosis is an acute, fatal infection caused by fungi of the family mucoraceae. The disease invariably occurs in diabetics, usually with ketoacidosis or immunocompromised patients. Typical initial symptoms of a patient with rhinocerebral mucormycosis are facial pain and swelling, headache, fever, and blood-tinged rhinorrhea. Symptoms rapidly progress to facial or orbital cellulitis, proptosis, and visual loss. Patients often may have infraorbital numbness, corneal anesthesia and facial nerve palsy. Recently, we experienced two cases of rhino-orbito-cerebral mucormycosis with atypical initial presentations. One case is a 54-year-old male, who had suddenly developed left facial palsy and periorbital swelling. The other is a 61-year-old female, who had right periorbital painful swelling with visual loss for 1 day. Herein we report the clinical courses and symptoms of these patients with literature review. Initial symptoms in making early diagnosis of rhino-orbito-cerebral mucormycosis are emphasized.
Anesthesia ; Blindness ; Early Diagnosis ; Exophthalmos ; Facial Nerve ; Facial Pain ; Facial Paralysis ; Female ; Fever ; Fungi ; Headache ; Humans ; Hypesthesia ; Immunocompromised Host ; Ketosis ; Male ; Middle Aged ; Mucormycosis* ; Orbital Cellulitis ; Paralysis