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Facial Nerve Palsy: An Unusual Presentation in Patients with Rhino Cerebral Mucormycosis

  • Rajashri ManeEmail author
  • Balasaheb Patil
  • Anjana Mohite
  • Roshni Mohanty
Original Article
  • 44 Downloads

Abstract

The aim of this study is to highlight involvement of facial nerve as a presenting symptom in rhino cerebral mucormycosis. A retrospective longitudinal study was carried out for a period of 1 year from May 2017 to May 2018 in Department of Otorhinolaryngology of Dr. D. Y. Patil Medical College and Hospital, Kolhapur. The usual presentation include nasal stuffiness, headache, eye pain and orbital swelling, ophthalmoplegia and visual loss. However we had four patients who presented to our OPD with facial nerve palsy and rhino cerebral mucormycosis. All four patients were diabetic. The available clinical and laboratory data was retrospectively collected and analyzed. Facial nerve palsy is an unusual but significant sign in presentation of mucormycosis. It could be misdiagnosed as CVA with subsequent delay in the treatment. A high index of suspicion for mucormycosis in diabetic patients presenting with facial palsy will be helpful in achieving early and accurate diagnosis with prompt management and better outcome.

Keywords

Rhino cerebral mucormycosis Mucormycosis Facial nerve palsy Complications of diabetes 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Institutional Ethics Committee.

References

  1. 1.
    Bouza E, Munoz P, Guinea J (2006) Mucormycosis: an emerging disease. Clin Microbiol Infect 12:7–23.  https://doi.org/10.1111/j.1469-0691.2006.01604.x CrossRefGoogle Scholar
  2. 2.
    Mane RS, Watve JK, Mohite AA et al (2007) Rhinocerebral mucormycosis: a deadly disease on the rise. Indian J Otolaryngol Head Neck Surg 59:112.  https://doi.org/10.1007/s12070-007-0034-1 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bakshi SS (2016) An unusual cause for facial nerve palsy: mucormycosis. Int J Diabetes Dev Ctries 36:385.  https://doi.org/10.1007/s13410-016-0468-7 CrossRefGoogle Scholar
  4. 4.
    Aloosi SN (2018) Facial nerve palsy as frequent presentation in patient with rhinocerebral mucormycosis. J Oral Dental Res 5(1):55–69Google Scholar
  5. 5.
    Hosseini SM, Borghei P (2005) Rhinocerebral mucormycosis: pathways of spread. Eur Arch Otorhinolaryngol 262:932–938CrossRefGoogle Scholar
  6. 6.
    Swift AC, Denning DW (1998) Skull base osteitis following fungal sinusitis. J Laryngol Otol 112(1):92–97CrossRefGoogle Scholar
  7. 7.
    Shekar V, Sikander J, Rangdhol V, Naidu M (2015) Facial nerve paralysis: a case report of rare complication in uncontrolled diabetic patient with mucormycosis. J Nat Sci Biol Med 6:226–228CrossRefGoogle Scholar
  8. 8.
    Pecket P, Schattner A (1982) Concurrent Bell’s palsy and diabetes mellitus: a diabetic mononeuropathy? J Neurol Neurosurg Psychiatry 45:652–655CrossRefGoogle Scholar
  9. 9.
    Safdar A, Jr DMP, Talwani R, Thompson CR (2002) Intracranial perineural extension of invasive mycosis: a novel mechanism of disease propagation by Aspergillus fumigatus. Clin Infect Dis 35(5):e50–e53CrossRefGoogle Scholar
  10. 10.
    Ferry AP, Abedi S (1983) Diagnosis and management of rhinoorbitocerebral mucormycosis (phycomycosis). A report of 16 personally observed cases. Ophthalmology 90:1096–1104CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyDr. D. Y. Patil Medical College and HospitalKolhapurIndia

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