Mucormicosis rinoorbitaria en paciente diabético: a propósito de un caso

María Virginia Reviglio; Armando Hausberger; Matías Osaba; Yukari Nigatake; María Inés González Castellanos; Víctor Reviglio

doi:10.70313/2718.7446.v17.n01.294

Authors

María Virginia Reviglio Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina
Armando Hausberger Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina
Matías Osaba Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina
Yukari Nigatake Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina
María Inés González Castellanos Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina
Víctor Reviglio Servicio de Oftalmología “Instituto de la Visión Cerro” Sanatorio Allende, Córdoba, Argentina

DOI:

https://doi.org/10.70313/2718.7446.v17.n01.294

Keywords:

diabetes mellitus, immunocompromised, ophthalmoplegia, mucormycosis, proptosis

Abstract

Objective: To report a case of rhinoorbital mucormycosis in a diabetic patient and its interdisciplinary management.

Clinical case: A 57-year-old male patient with a history of diabetes and hypertension presented with left eyelid ptosis and altered facial sensitivity of 15 days’ duration. Clinical examination revealed no light perception in the left eye proptosis, ptosis involving up to 1/3 of the cornea, ophthalmoplegia, and an unreactive pupil in the affected eye. Indirect binocular ophthalmoscopy revealed severe diabetic and hypertensive retinopathy. The patient was admitted with a presumptive diagnosis of an orbital tumor, and imaging studies and samples were obtained. Empirical treatment with ceftriaxone, vancomycin, and liposomal amphotericin B was initiated. Mucormycosis was isolated and the patient was rotated with liposomal amphotericin B for 21 days combined with isavuconazole for 9 days. Due to good clinical evolution, discharge with oral antimicrobial treatment and follow-up was decided.

Conclusion: Mucormycosis is a potentially fatal infection that requires timely diagnosis and intensive interdisciplinary management to halt the progression of the disease.

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