Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Rhinocerebral mucormycosis complicated by internal carotid artery thrombosis in a pediatric patient with type 1 diabetes mellitus: a case report and review of the literature. Pediatr Diabetes 2005 Dec;6(4):234-8

Date

01/05/2006

Pubmed ID

16390393

DOI

10.1111/j.1399-543X.2005.00118.x

Scopus ID

2-s2.0-29544439725 (requires institutional sign-in at Scopus site)   52 Citations

Abstract

OBJECTIVE: To illustrate that rapid diagnosis and aggressive treatment of rhinocerebral mucormycosis with internal carotid artery occlusion in a pediatric patient can prevent mortality and significant morbidity.

RESEARCH DESIGNS AND METHODS: Rhinocerebral mucormycosis infrequently occurs in the pediatric population, and when it involves thrombosis of an internal carotid artery, it has been almost uniformly fatal. We present an 8-yr-old girl with type 1 diabetes mellitus who has survived such an infection for 2 yr, and who has minimal residual morbidity. We believe she is the youngest patient to survive rhinocerebral mucormycosis complicated by internal carotid artery and cavernous sinus thromboses. She has survived with an intensive regimen including aggressive surgical debridement, amphotericin B, rigorous glucose control, hyperbaric oxygen therapy, interferon-gamma, posaconazole (an experimental antifungal), and granulocyte-macrophage colony-stimulating factor.

CONCLUSIONS: This article illustrates the importance of prompt recognition and aggressive treatment of fungal infection in patients with diabetes. Additionally, it emphasizes that such treatment can have an excellent outcome, and mortality and significant morbidity can be avoided. Finally, we provide a review of the literature regarding mucormycosis infections and treatment options.

Author List

Simmons JH, Zeitler PS, Fenton LZ, Abzug MJ, Fiallo-Scharer RV, Klingensmith GJ

Author

Rosanna V. Fiallo-Scharer MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Carotid Artery Thrombosis
Cavernous Sinus
Child
Combined Modality Therapy
Diabetes Mellitus, Type 1
Female
Humans
Magnetic Resonance Imaging
Mucor
Mucormycosis
Orbit
Paranasal Sinuses
Sinusitis
Telencephalon