Saudi Journal of Kidney Diseases and Transplantation

CASE REPORT
Year
: 2013  |  Volume : 24  |  Issue : 4  |  Page : 768--772

Rhino-orbitocerebral mucormycosis in a patient with idiopathic crescentic glomerulonephritis


Suzan Sanavi1, Reza Afshar2, Siamak Afshin-Majd3 
1 Parsa Hospital, Tehran, Iran
2 Department of Nephrology, Shahed University, Mustafa Khomeini Hospital, Tehran, Iran
3 Department of Neurology, Shahed University, Mustafa Khomeini Hospital, Tehran, Iran

Correspondence Address:
Suzan Sanavi
Parsa Hospital, Tehran
Iran

Mucormycosis, caused by mucorales, is an acute, rapidly progressive infection associated with high mortality. Rhino-orbitocerebral infection is the most common variant and is generally seen in association with immune deficiency syndromes. Prompt medical treatment of this infection and debridement decreases the mortality rate. We describe a 47-year-old man with crescentic glomerulonephritis on maintenance prednisolone therapy. He had earlier received steroid and cyclophosphamide pulse therapies. Renal functions improved following immunosuppressive treatment. In the third month of maintenance therapy, he presented to us with left-sided facial swelling and bloody nasal discharge. He had high blood sugar and acidic blood pH (ketoacidosis), probably due to steroid therapy. Magnetic resonance imaging of the head and sinuses showed inflammation and mass in the ethmoid sinus and nose with partial septal destruction, proptosis, global destruction of the left eye, brain infarction and carotid artery obliteration. Endoscopic biopsy of the sinuses revealed severe tissue necrosis. Samples of nasal discharge and biopsy tissue showed aseptate hyphae on light microscopy and culture, compatible with Rhizopus. The patient was treated with amphotericin B and multiple wound debridements along with ethmoidectomy and enucleation of the left eye. He was discharged in good general condition but with mild right hemiparesis. On follow-up examination at one year, there were no signs of fungal infection or renal dysfunction.


How to cite this article:
Sanavi S, Afshar R, Afshin-Majd S. Rhino-orbitocerebral mucormycosis in a patient with idiopathic crescentic glomerulonephritis.Saudi J Kidney Dis Transpl 2013;24:768-772


How to cite this URL:
Sanavi S, Afshar R, Afshin-Majd S. Rhino-orbitocerebral mucormycosis in a patient with idiopathic crescentic glomerulonephritis. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2020 Dec 3 ];24:768-772
Available from: https://www.sjkdt.org/article.asp?issn=1319-2442;year=2013;volume=24;issue=4;spage=768;epage=772;aulast=Sanavi;type=0