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Article ; Online: Magnetic resonance imaging in rhino-orbital-cerebral mucormycosis.

Sreshta, Kanduri / Dave, Tarjani Vivek / Varma, Dandu Ravi / Nair, Akshay Gopinathan / Bothra, Nandini / Naik, Milind N / Sistla, Srinivas Kishore

Indian journal of ophthalmology

2021 Volume 69, Issue 7, Page(s) 1915–1927

Abstract: ... Early diagnosis can be lifesaving. Magnetic resonance imaging (MRI) imaging remains the corner stone of management ... in patients with ROCM. This review discussed the utility of MRI imaging in ROCM with an emphasis on the ideal ... features, MRI for staging of the disease, MRI for prognostication, MRI for follow up, and imaging features ...

Abstract	Coronavirus disease-associated mucormycosis (CAM) is an established clinical entity in India. In the past 4 months, there has been a sharp upsurge in the number of CAM cases in most parts of the country. Early diagnosis can be lifesaving. Magnetic resonance imaging (MRI) imaging remains the corner stone of management in patients with ROCM. This review discussed the utility of MRI imaging in ROCM with an emphasis on the ideal MRI protocol in a suspected case of ROCM, the pathways of spread of infection, the classic diagnostic features, MRI for staging of the disease, MRI for prognostication, MRI for follow up, and imaging features of common differentials in ROCM. The pit falls of MRI imaging and a comparison of CT and MRI imaging in ROCM are discussed. The clinical interpretation of areas of contrast uptake and those of necrosis and its relevance to treatment are discussed. This review aims to familiarize every member of the multidisciplinary team involved in managing these patients to be able to interpret the findings on MRI in ROCM.
MeSH term(s)	Antifungal Agents/therapeutic use ; Humans ; India ; Magnetic Resonance Imaging ; Mucormycosis/diagnostic imaging ; Nose Diseases/drug therapy ; Orbital Diseases/diagnostic imaging ; Orbital Diseases/drug therapy
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2021-06-11
Publishing country	India
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	187392-1
ISSN	1998-3689 ; 0301-4738
ISSN (online)	1998-3689
ISSN	0301-4738
DOI	10.4103/ijo.IJO_1439_21
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Article ; Online: Magnetic resonance imaging spectrum of COVID-associated rhino-orbital-cerebral mucormycosis and assessment of anatomical severity.

Kumar, Ishan / Verma, Ashish / Dangwal, Jyoti / Singh, Pramod Kumar / Chandra Shukla, Ram / Chakravarty, Jaya

The neuroradiology journal

2022 Volume 36, Issue 4, Page(s) 404–413

Abstract: Objectives: To describe the extent and imaging findings of COVID-associated rhino-orbital-cerebral ... mucormycosis on magnetic resonance imaging and to evaluate the value of MRI severity score in grading ... Conclusion: A combination of magnetic resonance sequences is required to correctly evaluate the involvement ...

Abstract	Objectives: To describe the extent and imaging findings of COVID-associated rhino-orbital-cerebral mucormycosis on magnetic resonance imaging and to evaluate the value of MRI severity score in grading the extent of involvement. Methods: Proven cases of ROCM with a history of concurrent or recently (<6 weeks) treated COVID-19 underwent MRI at the initial presentation. Findings were charted for each anatomical structure and the extent of involvement was scored for sinonasal, extra-sinus soft tissues, orbits, and brain. MR severity score was defined by summing up the individual scores of each compartment (sinonasal 20, orbital 20, soft tissue 10, and brain 10) and a total score out of 60 was assigned. Results: A total of 47 patients were included in our study with variable involvement of sinonasal compartment ( Conclusion: A combination of magnetic resonance sequences is required to correctly evaluate the involvement of individual structures and thus to assign the correct MR scoring. The proposed MR severity score can effectively and objectively evaluate the severity of COVID-associated ROCM.
MeSH term(s)	Humans ; Mucormycosis/diagnostic imaging ; COVID-19/complications ; COVID-19/diagnostic imaging ; Eye Diseases ; Magnetic Resonance Imaging ; Paranasal Sinuses
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	2385-1996 ; 1971-4009 ; 1120-9976
ISSN (online)	2385-1996
ISSN	1971-4009 ; 1120-9976
DOI	10.1177/19714009221114442
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Article ; Online: Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India.

Hada, Maya / Gupta, Parul / Bagarhatta, Meenu / Tripathy, Koushik / Harsh, Anita / Khilnani, Kamlesh / Mendiratta, Kuldeep / Agarwal, Sunita / Chouhan, Jugal Kishore / Bhandari, Sudhir

Indian journal of ophthalmology

2022 Volume 70, Issue 2, Page(s) 641–648

Abstract: ... of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform ... Purpose: To study the clinical profile and magnetic resonance imaging (MRI) features in patients ... Conclusion: Orbital imaging features of a cohort of ROCM patients have been presented ...

Abstract	Purpose: To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation. Methods: A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs. Results: Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively. Conclusion: Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Female ; Humans ; India/epidemiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mucormycosis/diagnosis ; Mucormycosis/epidemiology ; Orbital Cellulitis ; Orbital Diseases/diagnosis ; Orbital Diseases/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2022-01-27
Publishing country	India
Document type	Journal Article
ZDB-ID	187392-1
ISSN	1998-3689 ; 0301-4738
ISSN (online)	1998-3689
ISSN	0301-4738
DOI	10.4103/ijo.IJO_1652_21
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Article ; Online: Magnetic Resonance Imaging in Coronavirus Disease - 2019 Associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) - Imaging Analysis of 50 Consecutive Patients.

Yadav, Taruna / Tiwari, Sarbesh / Gupta, Aanchal / Garg, Pawan Kumar / Khera, Pushpinder Singh / Rajagopal, Rengarajan / Goyal, Amit / Soni, Kapil / Chugh, Ankita / Jain, Vidhi / Sureka, Binit / Elhence, Poonam / Misra, Sanjeev

Current problems in diagnostic radiology

2021 Volume 51, Issue 1, Page(s) 112–120

Abstract: Background and purpose: Rhino-orbital-cerebral mucormycosis has emerged as a major ... Rhino-orbital-cerebral Mucormycosis (CA-ROCM) in a tertiary care hospital in India.: Materials and ... opportunistic infection in patients with COVID-19. High clinical suspicion and prompt imaging are crucial ...

Abstract	Background and purpose: Rhino-orbital-cerebral mucormycosis has emerged as a major opportunistic infection in patients with COVID-19. High clinical suspicion and prompt imaging are crucial for early diagnosis and management. Our study evaluates imaging characteristics of patients with COVID-19 associated Rhino-orbital-cerebral Mucormycosis (CA-ROCM) in a tertiary care hospital in India. Materials and methods: A retrospective analysis of clinical and imaging data of patients with CA-ROCM who presented between December 2020 to June 2021 was performed. All patients had microbiologically or histologically proven sino-nasal mucormycosis along with documented SARS-CoV-2 positive RT-PCR test and/or classical lung imaging features of COVID-19 infection. The extent of sinus involvement, bony erosions, extra-sinus soft tissue extension, orbital-intracranial invasion, perineural spread, and vascular complications were assessed. Results: Fifty patients were included for the final analysis. Diabetes was the most common associated comorbidity. Seven patients presented with stage I disease, 18 patients with stage II, and 25 patients with stage III disease. The stage of disease showed a positive statistical correlation with HbA1c levels using Pearson's correlation. The common imaging features were "Black turbinate sign" and nonenhancing sino-nasal mucosa (82%), orbital involvement (76%), and diffusion restriction in the optic nerve (24%). Intracranial involvement was seen as perineural extension into the brain (42%), cerebritis (30%), and internal carotid artery involvement (16%). Conclusions: CA-ROCM is an acute invasive fungal sinusitis with an aggressive clinical course. Black-turbinate sign and peri-antral soft tissue infiltration are early features, whereas extra-nasal tissue infarction, optic nerve diffusion restriction, and vascular invasion are seen with advanced disease.
MeSH term(s)	COVID-19 ; Humans ; Magnetic Resonance Imaging ; Mucormycosis/diagnostic imaging ; Orbital Diseases/diagnostic imaging ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-11-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	198954-6
ISSN	1535-6302 ; 0363-0188
ISSN (online)	1535-6302
ISSN	0363-0188
DOI	10.1067/j.cpradiol.2021.09.004
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Article ; Online: Magnetic resonance imaging of rhino-orbito-cerebral mucormycosis: a pictorial review.

Dixit, Rashmi / Gupta, Akarshi / Prakash, Anjali / Pradhan, Gaurav Shanker

Acta radiologica (Stockholm, Sweden : 1987)

2022 Volume 64, Issue 4, Page(s) 1641–1649

Abstract: ... magnetic resonance imaging (MRI) for disease evaluation and timely detection of intracranial complications. Angio-invasive ... Rhino-orbito-cerebral mucormycosis is a potentially fatal disease requiring early ... nature leading to necrosis and infarction is the hallmark of mucormycosis. The disease follows ...

Abstract	Rhino-orbito-cerebral mucormycosis is a potentially fatal disease requiring early magnetic resonance imaging (MRI) for disease evaluation and timely detection of intracranial complications. Angio-invasive nature leading to necrosis and infarction is the hallmark of mucormycosis. The disease follows a fulminant course extending from the paranasal sinuses to involve the orbit, deep neck spaces, skull base, facial bones, and intracranial compartment. Loss of vision either due to direct extension into the orbit or optic nerve infarction adds to disease morbidity. Prompt MRI using dedicated sequences can help in assessing the exact disease extent including early osseous and intracranial changes, which aid in precise disease management.
MeSH term(s)	Humans ; Mucormycosis/diagnostic imaging ; Mucormycosis/complications ; Orbital Diseases/diagnostic imaging ; Paranasal Sinuses ; Magnetic Resonance Imaging/adverse effects ; Infarction/complications
Language	English
Publishing date	2022-10-17
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	105-3
ISSN	1600-0455 ; 0284-1851 ; 0349-652X
ISSN (online)	1600-0455
ISSN	0284-1851 ; 0349-652X
DOI	10.1177/02841851221132788
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Article: Magnetic Resonance Imaging Features of Rhino-Orbito-Cerebral Mucormycosis in Post-COVID-19 Patients: Radio-Pathological Correlation.

Hassan, Rania Mostafa / Almalki, Yassir Edrees / Basha, Mohammad Abd Alkhalik / Gobran, Mai Ahmed / Alqahtani, Saad Misfer / Assiri, Abdullah M / Alqahtani, Saeed / Alduraibi, Sharifa Khalid / Aboualkheir, Mervat / Almushayti, Ziyad A / Aldhilan, Asim S / Aly, Sameh Abdelaziz / Alshamy, Asmaa A

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 9

Abstract: ... Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management ... There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus ... infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations ...

Abstract	There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus disease 2019 (COVID-19), which is an invasive fungal infection with a fatal outcome. Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management of these cases. This study aimed to describe the characteristic MRI findings of ROCM in post-COVID-19 patients to help in the early diagnosis and management of these patients. This retrospective descriptive study was conducted at a single hospital and included 52 patients with COVID-19 and a histopathologically proven ROCM infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations. Two radiologists reviewed all the MR images in consensus. The diagnosis was confirmed by histopathological examination. The maxillary sinus was the most commonly affected PNS (96.2%). In most patients (57.7%), multiple sinuses were involved with the black turbinate sign on postcontrast images. Extrasinus was evident in 43 patients with orbital involvement. The pterygopalatine fossa was involved in four patients. Three patients had cavernous sinus extension, two had pachymeningeal enhancement, and one had epidural collection. The alveolar margin was affected in two patients, and five patients had an extension to the cheek. The awareness of radiologists by the characteristic MRI features of ROCM in post-COVID-19 patients helps in early detection, early proper management, and prevention of morbid complications.
Language	English
Publishing date	2023-04-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13091546
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Article: Radiological Manifestations of Rhino-Orbito-Cranial Mucormycosis in COVID-19 Patients Correlated With Pathological and Clinical Outcomes and Emphasis on Magnetic Resonance Imaging-Based Scoring System.

Patil, Chandrasekhar / Kumar, Arun / Battula, Vasudha / Kumar, Prashanth / Kollu, Raja / Kotamraju, Sai / Nethi Balingari, Bhavana Lakshmi / Reddy, Sushmitha / Ravula, Smitha / Reddy, Akash R

Cureus

2023 Volume 15, Issue 3, Page(s) e35745

Abstract: ... we proposed a magnetic resonance imaging (MRI) based scoring system to standardize and prognosticate ... facial, cerebral parenchyma causing related complications and hence increased morbidity and death ... There was tremendous increase in the number of cases of mucormycosis among patients affected ...

Abstract	There was tremendous increase in the number of cases of mucormycosis among patients affected by coronavirus disease 2019 (COVID-19) during the second wave of pandemic in South Asian countries. This invasive fungal infection primarily affects paranasal sinuses and can have orbito-facial and intracranial extension. We are presenting the radiological findings of invasive mucormycosis with pathological and clinical outcome correlation. It is important for radiologists to have the knowledge of various presentations of this opportunistic infection for early diagnosis and helping clinicians in planning the appropriate line of management. The study also emphasizes on the correlation between the extent of involvement with clinical outcome and we proposed a magnetic resonance imaging (MRI) based scoring system to standardize and prognosticate the patients affected with mucormycosis. Materials and methods: We utilized GE 1.5 tesla, 16-channeled MRI machine for scanning the clinically suspected mucormycosis patients and did plain and contrast study of the paranasal sinuses, orbito-facial study and included brain as and when required. Images were acquired in axial, coronal, and sagittal planes using T1, T2, and fat-saturated short tau inversion recovery sequences (STIR), fat-saturated contrast sequences for better evaluation of the extent of the disease. Diffusion-weighted sequence was also acquired to detect ischemic changes in optic nerve or brain parenchyma. Contrast study was used to detect any major vessel occlusion or cavernous sinus thrombosis in the study population. Results: Total number of cases (n) included in the study were 32. The mean age group was 41-50 years with the median age was 47 years. Out of 32 cases (n=32), in 16 cases (50%) the disease was limited only to the paranasal sinuses and in remaining 16 (50%) cases, disease has spread to other regions such as orbits, facial soft tissues, optic nerve, and brain parenchyma. All the 18 cases with Mild score (MRI ROCM score 1-3) survived and all those with severe score (2 cases) (MRI ROCM score 7-10) did not survive. Conclusion: During the second wave of COVID-19 pandemic, we observed a signiﬁcant rise in acute invasive mucormycosis infection primarily involving the paranasal sinuses and spread to orbito-facial, cerebral parenchyma causing related complications and hence increased morbidity and death. Radiologically, using MRI, it was effectively possible to detect early extrasinonasal spread and other fatal complications thereby guiding the physicians and surgeons in the proper early aggressive management of the disease. Here, we have described the radiological characteristics of paranasal sinus mucormycosis and its spread to other regions. We also proposed an MRI-based Scoring System for standardized assessment of the disease severity. We observed in our study that the extent of disease on MRI is directly correlating with mortality.
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.35745
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Article ; Online: Imaging spectrum of mucormycosis in COVID-19 patients using computed tomography and magnetic resonance imaging

Rakhi Chhikara / Manish Kumar / Rohit Kaushik / Simran Gupta / Lalit Kumar / Nitesh Mohan

Apollo Medicine, Vol 19, Iss 2, Pp 89-

2022 Volume 95

Abstract: ... appearance in rhino-orbital form of mucormycosis. Rhinocerebral form showed contiguous spread of the disease ... tomography (CT) and magnetic resonance imaging (MRI) were used for imaging evaluation of the patients ... of mucormycosis are rhino-orbito-cerebral, pulmonary, gastrointestinal, cutaneous, disseminated, and uncommon ...

Abstract	Introduction: COVID-19 is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2. Imaging plays an essential role in the diagnosis and management of symptomatic patients. Mucormycosis has gained popularity recently as a complication in COVID-19-affected patients. Various types of mucormycosis are rhino-orbito-cerebral, pulmonary, gastrointestinal, cutaneous, disseminated, and uncommon forms. Aim and Objective: We aimed to evaluate various radiological features of different types of mucormycosis infection in COVID-19 patients. Materials and Methods: We studied thirty COVID-19 patients retrospectively who were referred to our hospital over a period of 6 months (January to June 2021). Computed tomography (CT) and magnetic resonance imaging (MRI) were used for imaging evaluation of the patients. Imaging diagnosis was confirmed on histopathology in 21 patients. Results: We identified thirty cases of mucormycosis in COVID-19 patients in our tertiary center. Out of total cases, 18 were of pulmonary form, 9 of rhino-orbital form, and 3 of rhinocerebral form. Bird's nest pattern of cavitation was the most common feature in pulmonary form of mucormycosis. Acute unilateral rhinosinusitis with the presence of T2 hypointensities within periantral and intraorbital fat stranding was found to be the most specific imaging appearance in rhino-orbital form of mucormycosis. Rhinocerebral form showed contiguous spread of the disease from the sinuses to the meninges and brain parenchyma. Conclusion: Imaging plays a decisive role for early identification of the mucormycosis infection in COVID-19 patients and determination of the disease extent. CT and MRI help in accurate diagnosis of the disease and follow-up in postoperative patients.
Keywords	bird's nest sign ; mucormycosis ; reversed halo sign ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article ; Online: Spectrum of magnetic resonance imaging findings in post-COVID-19 patients presenting with rhino-orbito-cerebral mucormycosis in a teaching hospital in Malwa region of Punjab

Pushpinder Singh / Kiranjeet Kaur / Vinita Jindal / Manjot Kaur / Mandeep Kaur / Navdeep Singh

Journal of Family Medicine and Primary Care, Vol 11, Iss 12, Pp 7788-

2022 Volume 7794

Abstract: ... to describe the characteristic magnetic resonance imaging (MRI) findings in invasive mucormycosis and ... Background: Rhino-orbito-cerebral-mucormycosis (ROCM) associated with COVID-19 infection was ... of ROCM, MRI imaging helps in early diagnosis and staging/severity of ROCM, so that timely intervention ...

Abstract	Background: Rhino-orbito-cerebral-mucormycosis (ROCM) associated with COVID-19 infection was at its peak during and immediately after the second wave of the pandemic in India during 2021. Many of the risk factors were implicated in the development of this deadly fungal infection, when there was a sudden surge of cases, especially who had a history of COVID-19 infection. Objectives: The objective of the study was to describe the characteristic magnetic resonance imaging (MRI) findings in invasive mucormycosis and to evaluate the extent and severity of invasive mucormycosis. Materials and Methods: A retrospective study was carried out for 4 months which included 60 patients who underwent MRI using a Siemens Avanto 1.5 Tesla scanner. During our study, 68 cases were selected based on clinicoradiological features suspected of ROCM. However, 8 patients were excluded on the basis of exclusion criteria as either there was no definitive evidence of COVID infection or were proven to be negative for mucormycosis on microbiological examination. Results: On the basis of the spectrum of MRI findings, post-COVID-19 related ROCM was broadly categorized into three stages. Out of total of 60 patients, the disease was localized to the nasal and paranasal sinus region (Stage I) in 7 patients (11.66%), extending to adjacent extrasinus orofacial soft tissue structures (Stage II) in 36 patients (60%), and intracranial extension of disease (Stage III) was seen in 17 patients (28.33%). Conclusion: In post-COVID-19 patients presenting with clinical features suspected of ROCM, MRI imaging helps in early diagnosis and staging/severity of ROCM, so that timely intervention can be planned to reduce mortality as well as morbidity.
Keywords	black turbinate sign ; covid-19 ; mucormycosis ; orbital cellulitis ; rocm ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: Rhinocerebral mucormycosis in IDDM. Sequential magnetic resonance imaging of long-term survival with intensive therapy.

Moll, G W / Raila, F A / Liu, G C / Conerly, A W

Diabetes care

1994 Volume 17, Issue 11, Page(s) 1348–1353

Abstract: ... magnetic resonance imaging (MRI) in the successful management of an often fatal fungal infection in a 12-year-old patient ... Our patient is among the youngest of IDDM patients reported to have survived rhinocerebral mucormycosis ... with obvious left orbital involvement and left cranial nerve palsies by 72 h of hospitalization. CT and MRI ...

Abstract	Objective: To describe the clinical course and the utility of computerized tomography (CT) and magnetic resonance imaging (MRI) in the successful management of an often fatal fungal infection in a 12-year-old patient with insulin-dependent diabetes mellitus (IDDM). Case: The patient was admitted to The University of Mississippi Medical Center (UMC) for the purpose of diabetic ketoacidosis (DKA) management and subsequent intensive therapy for mucormycosis according to nationally accepted standards of care. Strict diabetic control was instituted with frequent monitoring of blood glucose levels and interval assessment of HbA1c. Sequential MRI studies were obtained according to approved patient standards; the clinical and MRI course of the infection was charted. Results: The patient's DKA resolved within 12 h on intravenous fluid repletion and insulin therapy. His sinusitis/rhinitis noted on admission did not respond to intravenous antibiotic therapy and progressed with obvious left orbital involvement and left cranial nerve palsies by 72 h of hospitalization. CT and MRI were invaluable aids to the early diagnosis and design of appropriate surgical and antifungal management of this patient, who survived with minimal left cranial nerve palsies. Conclusions: Our patient is among the youngest of IDDM patients reported to have survived rhinocerebral mucormycosis. His survival is attributed to early recognition of possible mucormycosis with diagnostic support of CT and MRI, surgical debridement and antifungal therapy, and intensive blood glucose control. Sequential MRI is invaluable to the design of therapy for this type of patient and shows the nearly 3-year recovery from mucormycosis.
MeSH term(s)	Brain Diseases/complications ; Brain Diseases/diagnosis ; Child ; Diabetes Mellitus, Type 1/complications ; Diabetic Ketoacidosis/complications ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/complications ; Mucormycosis/diagnosis ; Sinusitis/complications ; Sinusitis/diagnosis
Language	English
Publishing date	1994-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/diacare.17.11.1348
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