Indolent orbital apex syndrome caused by occult mucormycosis

David P. Dooley, Donald A. Hollsten, Steven R. Grimes, Jesse Moss

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

The chronic or indolent presentation of rhino-orbital mucormycosis, as defined by the presence of symptoms for more than 1 month before diagnosis, is extremely unusual. A 45-year-old man with stable diabetes presented with a right orbital apex syndrome and minimal ethmoid and sphenoid sinusitis. Progression was indolent, and the diagnosis was not made until 7 weeks after admission, when a third biopsy was prompted by new cavernous sinus and carotid artery thromboses. Mucormycosis was found. The patient improved on amphotericin B (2 g) and strict blood glucose control. A remarkable aberrant regeneration of the right oculomotor nerve was seen following treatment. He remains free of active disease 4 years later. Orbital symptoms in well-controlled diabetics, which may even remain stable for weeks and lack direct signs of tissue invasion, should raise the suspicion of mucormycosis.

Original languageEnglish (US)
Pages (from-to)245-249
Number of pages5
JournalJournal of Clinical Neuro-Ophthalmology
Volume12
Issue number4
StatePublished - Dec 1992
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

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