aggressive management of the case. Diagnosis of rhino-orbito-cerebral mucormycosis is made either by a successful culture of infected tissue or microscopic identification of the nonseptated fungus. Result of routine laboratory examinations are variable and non diagnostic14,15. Management of infection begins with the control of the underlying disease process. This enables the host to regain his or her natural resistance. Surgical debridement of all infected tissue which may be extensive should be done Therapy should also include treatment with the fungistatic antibiotic agent amphotericin B as was done here in this case. The use of systemic steroids & antibiotics should be judicious.
CONCLUSION A high index of clinical suspicion is required to make the diagnosis of rhinoorbital mucormycosis in a patient with uncontrolled diabetes who presents with headache, facial pain and proptosis. Imaging techniques may be suggestive of mucormycosis but are rarely diagnostic. Surgical exploration with biopsy of the areas of suspected infection should always be performed in high risk patients to confirm the diagnosis. It is critically important to understand that if mucormycosis is suspected, initial empirical therapy with amphotericin B should begin while the diagnosis is being confirmed16.
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EuVision Peer-reviewed Journal of Ophthalmology 1/10