జర్నల్ ఆఫ్ క్లినికల్ అండ్ ఎక్స్పెరిమెంటల్ ఆప్తాల్మాలజీ
అందరికి ప్రవేశం
ISSN: 2155-9570
ISSN: 2155-9570
Sonali Prasad*, Aman Gaur, Anuj Mehta, Nimisha Kaushal
Aim: Mucormycosis is a potentially lethal, angio-invasive fungal infection caused by the Mucoracea family comprising mucor, rhizopus, and absidia species. It is commonly associated with uncontrolled diabetes mellitus, use of corticosteroids, immunosuppressive drugs and COVID-19 infection. The occurrence of mucormycosis in an immunocompetent patient is rare. Also, only a few case reports have been published where patients developed mucormycosis with associated malarial infection.
Observations: A young female presented with a 3 weeks history of painful swelling and outward protrusion of the right eye with complete loss of vision. She had a history of P.vivax malaria two weeks prior to her ocular symptoms. On ocular examination, there was proptosis, total ophthalmoplegia with loss of corneal sensations in the right eye. Hematological examination revealed normocytic normochromic anemia and thrombocytopenia. MRI was suggestive of right-sided pansinusitis and orbital cellulitis with right superior ophthalmic vein thrombosis and bulky cavernous sinus.
Nasal biopsy was negative for fungal culture. An emergency surgical debridement of all the sinuses was done with right orbital exenteration. Histopathology confirmed the diagnosis of mucormycosis and the patient improved post-operatively on systemic antifungals.
Conclusion: Such an association of mucormycosis with malaria infection is rarely reported in the literature and is hypothesized to be a result of immunosuppression caused by malaria. Also, emphasis is laid upon having a high index of suspicion for fungal infection in the setting of pansinusitis even if the risk factors are absent.
We hereby report a case of rhino-orbital mucormycosis following P.vivax malaria in a 20-year-old female with anemia and thrombocytopenia.