Abstract

CASE REPORT ON RHINO ORBITAL MUCORMYCOSIS AND CEREBRAL ANEURYSM RUPTURE

Wajeeha Qhudsia Siddiqua*, Sameera Fatima, Ayesha Ambereen, Ayesha Asif Ali, Raheemunissa and Pratik Patil

ABSTRACT

Mucormycosis is a life-threatening invasive fungal infection primarily affecting immunocompromised individuals. Despite an increase in reported Mucorales-associated infections during the COVID-19 pandemic, cases of rhino-orbital mucormycosis complicated by cerebral aneurysm rupture with subsequent cerebral and brainstem infarct remain rare. Case presentation: We present the case of a 25-year-old male with a history of rhino-orbital mucormycosis, diagnosed on 22/6/23 (confirmed by histopathological examination), and undergoing treatment with Posaconazole. After seven days, the patient developed left eye ophthalmoplegia and proptosis, accompanied by persistent fever spikes. Antibiotic therapy was intensified. CT brain imaging revealed acute infarctions in the left thalamus, left parasagittal occipital region, bilateral cerebellar hemispheres, and right middle cerebellar peduncle, with mass effect leading to effacement of adjacent cisternal spaces, the fourth ventricle, and the aqueduct of Sylvius.
Despite aggressive medical management, the patient's sensorium did not improve, and he subsequently developed bradycardia followed by cardiac arrest. Immediate CPR was initiated, but no pulse or blood pressure could be detected. Regrettably, the patient could not be revived and was pronounced dead.

Keywords: Rhino-orbital mucormycosis, Cerebral aneurysm, Immunocompromised, Fluconazole, Ophthalmoplegia.