- J Korean Neurol Assoc. 2002;20(5):467-474.
- "he Clue for Early Diagnosis and Prediction of Intracranial Involvement in Rhinocerebral Mucormycosis"
- Ji-Man Hong, M.D
- Department of Neurology, School of Medicine, Ajou University
- "비대뇌 모균병에서 빠른 진단 및 두개강 내 침범의 예측에 도움이 되는 소견"
- 홍지만 , 한병인 ·신상건 ·방오영 ·김장성
- 아주대학교 병원 신경과
- Abstract
- "Background : Rhinocerebral mucormycosis (RCM) is an uncommon and fatal clinical syndrome resulting from an
opportunistic infection caused by a fungus of the order Mucorales in immunocompromized patients. The mortality and
morbidity in the patients with intracranial involvement is invariably high, and it was reported that most survivors had
early diagnosis and received aggressive treatment. Therefore, we retrospectively reviewed four patients of pathological-ly
confirmed mucormycosis to find out the clues for early diagnosis of RCM and for prediction of fatal intracranial
involvement. Methods : The clinical, radiological features and histo-pathological involvement sites in the patients with
intracranial involvement were compared to those without intracranial involvement. Results : All the patients had uncon-trolled
diabetes and were admitted with orbital involvement. On the precise physical examination, mucosal involvement
was found in all patients; three of them in only nasal mucosa and one in oral palatal mucosa. Despite the vigorous anti-fungal
therapy, two patients had intracranial involvement and expired. MRI finding of extensive sphenoid sinusitis adja-cent
cavernous sinus preceded the intracranial involvement of RCM, which was not found in the patients without
intracranial involvement. Conclusions : Our findings suggest that early observation of oral or nasal mucosal changes
might be an important clinical clue for differentiation of RCM from other causes of rhino-oculo-cerebral symptoms in
uncontrolled diabetic patients, and that extensive sphenoid sinusitis might be an important radiological feature for pre-dicting
the fatal intracranial involvement of RCM.Key words : Rhinocerebral mucormycosis, Intracranial involvement, Diabetes mellitus"
Keywords :