Case Report : Rhinoorbital Zygomycosis With Disseminated Disease In Immunocompetent Patient

1. Fadzlina A R ^1,2
2. Angeline N D C²
3. Nazila A A²
4. Sharifah Intan S O²
5. J Alagaratnam²

¹University Malaya Medical Centre,Kuala Lumpur, Malaysia
²Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

Purpose:
To report a rare case of rhinoorbital zygomycosis infection disseminating to lung and bone marrow in immunocompetent patient.

Method:
An interventional case report.

Result:
A sixty four year old healthy Chinese man with a year history of sinusitis presented with left left subperiosteal orbital abscess that complicated to osteomyelitis of left maxilla. His condition progressed to had orbital invasion from the ethmoidal and maxilla. Biopsy revealed fungal infiltration. Later the eye was exenterated and debridement of necrotic tissue was performed. Patient deteriorated with shortness of breath and anaemia. Chest x-ray showed lung infection and bone marrow trephine revealed fungal infiltration.Despite liposomal amphotericin B and repeated debridements patient had septicaemia and succumbed to his illness.

Conclusion:
Rhinoorbital zygomycosis, particularly systemic infiltration with extreme age are significant risk factors for mortality. Lipid formulations of amphotericin B and surgical debridement are the mainstay treatment for zygomycosis.