Case Report

Rhino-Sino-Cerebral Mucormycosis Associated with Long-Term Rituximab Therapy in Multiple Sclerosis: A Case Report and Review of the Literature

a case report and review of the literature


Rituximab is a CD20 depleting agent, widely used as an off-label disease- modifying treatment (DMT) in treating multiple sclerosis (MS). The present study aimed to report the first case of rhino-sino-cerebral mucormycosis in a patient with secondary progressive MS (SPMS), treated with rituximab.The patient was a 38-year-old man with a history of SPMS treated with rituximab, who developed subacute left vision loss and impaired ocular movement. He also mentioned a concomitant severe headache and cheek swelling. Based on the brain and orbital magnetic resonance imaging (MRI) findings, rhino-sino-cerebral mucormycosis was suspected. Subsequent endoscopic examination confirmed the diagnosis. He underwent medical treatment with amphotericin B liposomal and surgical debridement leading to a significant clinical recovery. He was eventually discharged home with a solid recommendation to discontinue rituximab. The present report indicates a case of SPMS treated with rituximab, who developed rhino-sino-cerebral mucormycosis.

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IssueVol 7 No 6 (2022): November-December QRcode
SectionCase Report(s)
Multiple sclerosis Rituximab B-Lymphocytes Mucormycosis

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How to Cite
Koosha M, Mehrparvar G, Paybast S. Rhino-Sino-Cerebral Mucormycosis Associated with Long-Term Rituximab Therapy in Multiple Sclerosis: A Case Report and Review of the Literature. CRCP. 2023;7(6):313-318.