Isolated Orbital Mucormycosis in an Immunocompetent Adolescent.
Author: Jolie Krystle H. Guevara
Author Affiliations: University of the East Ramon Magsaysay Memorial Medical Center, Manila, Philippines
[button link=”http://msrj.chm.msu.edu/wp-content/uploads/2014/07/MSRJ-Spring-2014-Isolated-Orbital-Mucormycosis.pdf” type=”icon” icon=”download” color=green] Full Text Article PDF[/button]
Corresponding Author: Jolie Krystle H. Guevara; Jolieg800[at]gmail.com
Key Words: rhinocerebral; zygomycosis; pediatric; amphotericin B; corticosteroids; exenteration.
Abstract: Introduction and patient profile: Mucormycosis is a life-threatening disease that usually affects patients with diabetes and other immunocompromised states. However, recent literature has shown an emergence of this disease in immunocompetent individuals. Here we are presenting a rare case of a healthy 13-year-old adolescent diagnosed to have isolated orbital mucormycosis, previously treated with oral and intravenous corticosteroids. The patient presented with a chief complaint of left eye swelling of 3 weeks’ duration, which progressed to proptosis and a visual acuity of no light perception. Interventions and outcomes: Diagnosis of mucormycosis was done using histopathological techniques supported by radiologic imaging. Successful treatment of mucorymycosis was achieved via amphotericin B administration and orbital exenteration in this case. Discussion: The use of corticosteroids may weaken the immune system of healthy patients and can cause rapid progression of the disease. Early clinical diagnosis is important because this infection can rapidly be fatal.
Published on Date: May 31, 2014
Senior Editor: Jon Zande
Junior Editor: Romina Kim
Citation: Guevara JKH. Isolated Orbital Mucormycosis in an Immunocompetent Adolescent. Medical Student Research Journal. 2014;3(Spring):55-9.
1. Venkatachalam VP, Anand N. Paranasal mucormycosis: unusual representation in otherwise healthy child. Indian J Otolaryngol Head Neck Surg 2007; 59: 2646.
2. De Mol P, Meis JM. Disseminated Rhizopus microsporus infection in a patient on oral corticosteroid treatment: a case report. Neth J Med 2009; 67(1): 258.
3. Grewal RK, Grewal SS, Zachariah RM. Orbital mucormycosis (phycomycosis). Indian J Ophthalmol 1985; 33(4): 23941.
4. Shinde RV, Karande GS, Mohite ST, Patil SR. Rhino-orbital mucormycosis in diabetes mellitus. J Clin Diagn Res 2013; 7(6): 11457. http://dx.doi.org/10.7860/JCDR/2013/5528. 3083.
5. Badiee P, Jafarpour Z, Alborzi A, Haddadi P, Rasuli M, Kalani M. Orbital mucormycosis in an immunocompetent individual. Iran J Microbiol 2012; 4(4): 21014.
6. Bharathi R, Arya AN. Mucormycosis in an immunocompetent patient. J Oral Maxillofac Pathol 2012; 16(2): 3089. http://dx.doi.org/10.4103/0973-029X.99100.
7. Shatriah I, Mohn-Amin N, Tuan-Jaafar TN, Khanna RJ, Yunus R, Madhavan M. Rhino-orbital cerebral mucormycosis in an immunocompetent patient: case report and review of literature. Middle East Afr J Ophthalmol 2012; 19(2): 25861. http://dx.doi.org/10.4103/0974-9233.95269.
8. Mignogna M, Fortuna G, Leuci S, Adamo D, Ruoppo E, Siano M, et al. Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature. Int J Infect Dis 2011; 15(8): e53340. http://dx.doi.org/10.1016/j.ijid.2011.02.005.
9. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis 2012; 54(s1): s2334. http://dx.doi.org/10.1093/cid/cir866.
10. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005; 41: 63453. http://dx.doi.org/10.1086/432579.
11. Ferguson AD. Rhinocerebral mucormycosis acquired after a short course of prednisone therapy. J Am Osteopath Assoc 2007; 107(11): 4913.
12. Alsuhaibani AH, Thubaiti GA, Al Badr FB. Optic nerve thickening and infarction as the first evidence of orbital involvement with mucormycosis. Middle East Afr J Ophthal 2012; 19(3): 3402. http://dx.doi.org/10.4103/0974-9233. 97957.
13. Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J, Ibrahim AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 2009; 48(12): 174351. http://dx.doi.org/10.1086/599105.
14. Kontoyiannis DP, Lewis RE. Invasive zygomycosis: update on pathogenesis, clinical manifestations, and management. Infect Dis Clin North Am 2006; 20(3): 581607.
15. Schleimer RP, Kato A, Peters A, Conley D, Kim J, Liu MC, et al. Epithelium inflammation and immunity in the upper airways of humans: studies in chronic rhinosinusitis. Proc Am Thorac Soc 2009; 6(3): 28894. http://dx.doi.org/10.1513