Endocrine Abstracts

Introduction: Mucormycosis is an unusual but serious fungal infection that most commonly affects people with diabetes mellitus. Treatment shoud be initiated urgently and associates antifungal treatment, surgical resection and control of risk factors. This infection is associated with high morbidity and mortality rates.

Case reports: We report three cases of rhinosinusal mucormycosis occuring occurring in one female and two males. The medium age of the patients was 57 years ranging from 52 to 65 years. Uncontroled diabetes was noted in the three cases. The first case was presented with a 4-day history of left facial oedema, exophtalmos and nasal obtsruction. The second and the third cases were presented with septic shock and an extensive acute nasal skin necrosis. There was no history of fever, purulent discharge, paresthesia and foul odor. On examination, edema of the left hemiface as well as oculomotor paralysis and exophthalmos were noted for the first case, highly inflammatory nasal mucosa, purulent secretions, periortbital edema and black necrotic spot over the hemiface for the other cases. Facial CT scan examination showed signs of mucormycosis : maxillary, sphenoidal and ethmoidal sinusitis, with extension towards the soft tissues, bone erosion and orbit involvement in all the cases. Histological findings were consistent with mucormycosis.

Amphotericin B in combination with surgical debridement was used in the treatment of all the cases. A fatal outcome was noted in 2 cases.

Conclusion: Uncontrolled diabetes mellitus is considered to be the main predisposing factor for rhinosinusal mucormycosis. To prevent and reduce mortality rate of this acute disease, early diagnosis based on clinical findings and biopsy is recommended.