Rhino-orbital Mucormycosis in an Immunocompetent Pediatric Patient, Resembling an Orbital Mass- A Case Report
-
Seyed Mohsen Rafizadeh
,
Mehdi Aminizade
,
Fahime Asadi Amoli
,
Mahtab Rabbani Anari
,
Mahmoud khodabandeh
,
abbas mohammadi
Abstract
Rhino-orbital mucormycosis in an immunocompetent pediatric patient can present as an orbital mass. We report a 9-year-old male that presented with periorbital swelling and limitation of left eye movement from one month ago. The patient was treated at another center with a diagnosis of mucormycosis but was referred due to worsening symptoms. Orbital and paranasal sinus CT scan revealed opacities in the left paranasal sinus and soft tissue density in the medial and inferior orbital wall. The patient underwent orbitotomy and mass debulking surgery on suspicion of a possible neoplastic mass. Pathologic evaluations revealed mucormycosis. After receiving intravenous liposomal amphotericin-B that was followed by oral posaconazole syrup for two months and sinus debridement, the symptoms regressed. In immunocompromised pediatric patients, mucormycosis should be considered in the differential diagnosis of an orbital mass.
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[7] Neblett Fanfair R, Benedict K, Bos J, Bennett SD, Lo YC, Adebanjo T, et al. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med. 2012 Dec 6;367(23):2214-25. doi: 10.1056/NEJMoa1204781. PMID: 23215557.
[8] Skiada A, Rigopoulos D, Larios G, Petrikkos G, Katsambas A. Global epidemiology of cutaneous zygomycosis. Clin Dermatol. 2012 Nov-Dec;30(6):628-32. doi: 10.1016/j.clindermatol.2012.01.010. PMID: 23068150.
[9] Sarkar S, Jash D, Maji A, Maikap MK. Solitary pulmonary nodule: A rare presentation of pulmonary
mucormycosis in an immunocompetent adult. Lung India. 2014 Jan;31(1):70-2. doi: 10.4103/0970- 2113.125991. PMID: 24669089; PMCID: PMC3960817.
[10]Hamilos G, Samonis G, Kontoyiannis DP. Pulmonary mucormycosis. Semin Respir Crit Care Med. 2011 Dec;32(6):693-702. doi: 10.1055/s-0031-1295717. Epub 2011 Dec 13. PMID: 22167397.
[11]Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med. 1999 Jun
28;159(12):1301-9. doi: 10.1001/archinte.159.12.1301. PMID: 10386506.
[12]Ayoade F, Cloke C, Quiroz T, Tjendra Y. A case of rhinoorbital mucormycosis in an immunocompetent patient following Hurricane Irma. IDCases. 2019 Jul 20; 18: e00603. doi: 10.1016/ j.idcr. 2019.e00603. PMID: 31388490; PMCID: PMC6669373.
[13]Venkatesh D, Dandagi S, Chandrappa PR, Hema KN. Mucormycosis in immunocompetent patient resulting
in extensive maxillary sequestration. J Oral Maxillofac Pathol. 2018 Jan;22(Suppl 1): S112-S116. doi: 10.4103/jomfp.JOMFP_163_17. PMID: 29491619; PMCID: PMC5824503.
[14]Manesh A, John AO, Mathew B, Varghese L, Rupa V, Zachariah A, et al. Posaconazole: an emerging therapeutic option for invasive rhino-orbito-cerebral mucormycosis. Mycoses. 2016 Dec;59(12):765-772. doi:
10.1111/myc.12529. Epub 2016 Jul 22. PMID: 27443253.
[15]Chawla B, Sharma S, Kashyap S, Kabra SK, Pushker N, Bajaj MS. Primary orbital mycosis in immunocompetent infants. J AAPOS. 2011 Apr;15(2):211-3. doi: 10.1016/j.jaapos.2010.12.016. PMID: 21596302.
[16]Wagh VB, Kabra SK, Kashyap S, Avyact A, Pathak H, Sharma V, et al. Rarepresentation of fungal orbital cellulitis in an immunocompetent infant. J Pediat Ophthalmol Strabismus. 2007 Mar-Apr;44(2):127-9. doi: 10.3928/01913913-20070301-08. PMID: 17410966.
[2] Dan M. Mucormycosis of the head and neck. Curr Infect Dis Rep. 2011 Apr;13(2):123-31. doi: 10.1007/s11908-010 0162-8. PMID: 21365375.
[3] Swain SK, Sahu MC, Banerjee A. Non-sinonasal isolated facio-orbital mucormycosis - A case report. J Mycol Med. 2018 Sep;28(3):538-541. doi: 10.1016/j.mycmed.2018.05.003. PMID: 29773436.
[4] Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DCM, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019
Jan;25(1):26-34. doi: 10.1016/j.cmi.2018.07.011. Epub 2018 Jul 21. PMID: 30036666. 50 Rafizadeh S.M, et al. Rhino-orbital Mucormycosis, Resembling an Orbital Mass. CRCP. 2023; 8(1): 47-50
[5] Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect. 2020 Jul;26(7): 944.e9- 944.e15. doi: 10.1016/j.cmi.2019.11.021. Epub 2019 Dec 4. PMID: 31811914.
[6] Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, Savio J, et al. A prospective multicenter study on
mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol. 2019 Jun 1;57(4):395-402. doi: 10.1093/mmy/myy060. PMID: 30085158.
[7] Neblett Fanfair R, Benedict K, Bos J, Bennett SD, Lo YC, Adebanjo T, et al. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med. 2012 Dec 6;367(23):2214-25. doi: 10.1056/NEJMoa1204781. PMID: 23215557.
[8] Skiada A, Rigopoulos D, Larios G, Petrikkos G, Katsambas A. Global epidemiology of cutaneous zygomycosis. Clin Dermatol. 2012 Nov-Dec;30(6):628-32. doi: 10.1016/j.clindermatol.2012.01.010. PMID: 23068150.
[9] Sarkar S, Jash D, Maji A, Maikap MK. Solitary pulmonary nodule: A rare presentation of pulmonary
mucormycosis in an immunocompetent adult. Lung India. 2014 Jan;31(1):70-2. doi: 10.4103/0970- 2113.125991. PMID: 24669089; PMCID: PMC3960817.
[10]Hamilos G, Samonis G, Kontoyiannis DP. Pulmonary mucormycosis. Semin Respir Crit Care Med. 2011 Dec;32(6):693-702. doi: 10.1055/s-0031-1295717. Epub 2011 Dec 13. PMID: 22167397.
[11]Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med. 1999 Jun
28;159(12):1301-9. doi: 10.1001/archinte.159.12.1301. PMID: 10386506.
[12]Ayoade F, Cloke C, Quiroz T, Tjendra Y. A case of rhinoorbital mucormycosis in an immunocompetent patient following Hurricane Irma. IDCases. 2019 Jul 20; 18: e00603. doi: 10.1016/ j.idcr. 2019.e00603. PMID: 31388490; PMCID: PMC6669373.
[13]Venkatesh D, Dandagi S, Chandrappa PR, Hema KN. Mucormycosis in immunocompetent patient resulting
in extensive maxillary sequestration. J Oral Maxillofac Pathol. 2018 Jan;22(Suppl 1): S112-S116. doi: 10.4103/jomfp.JOMFP_163_17. PMID: 29491619; PMCID: PMC5824503.
[14]Manesh A, John AO, Mathew B, Varghese L, Rupa V, Zachariah A, et al. Posaconazole: an emerging therapeutic option for invasive rhino-orbito-cerebral mucormycosis. Mycoses. 2016 Dec;59(12):765-772. doi:
10.1111/myc.12529. Epub 2016 Jul 22. PMID: 27443253.
[15]Chawla B, Sharma S, Kashyap S, Kabra SK, Pushker N, Bajaj MS. Primary orbital mycosis in immunocompetent infants. J AAPOS. 2011 Apr;15(2):211-3. doi: 10.1016/j.jaapos.2010.12.016. PMID: 21596302.
[16]Wagh VB, Kabra SK, Kashyap S, Avyact A, Pathak H, Sharma V, et al. Rarepresentation of fungal orbital cellulitis in an immunocompetent infant. J Pediat Ophthalmol Strabismus. 2007 Mar-Apr;44(2):127-9. doi: 10.3928/01913913-20070301-08. PMID: 17410966.
| Files | ||
| Issue | Vol 8 No 1 (2023): Janyary-February | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i1.13101 | |
| Keywords | ||
| Mucormycosis Immunocompetent Orbital mass Pediatric | ||
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How to Cite
1.
Rafizadeh SM, Aminizade M, Asadi Amoli F, Rabbani Anari M, khodabandeh M, mohammadi abbas. Rhino-orbital Mucormycosis in an Immunocompetent Pediatric Patient, Resembling an Orbital Mass- A Case Report. CRCP. 2023;8(1):46-49.
