The authors describe a case of open brain injury caused by a 30 cm long knife, which penetrated the right orbit, the point of which reached as far as the right posterior fossa. The patient survived with minor neurologic deficit in relation to the extensive lesion.

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Key Clinical Message: Invasive fungal mucormycosis and its outcome as SIADH and orbital apex syndrome is uncommon. Mucormycosis in paranasal sinuses can even lead to intracranial invasion and its treatment with the use of amphotericin B can cure improve the prognosis of the disease. Early diagnosis and prompt treatment with antifungal, endoscopic surgery, and controlling of diabetes can be beneficial.

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Background: Mucormycosis is a highly lethal opportunistic fungal disease caused by ubiquitous molds of the order Mucorales, with Rhizopus, Lichtheimia and Mucor being the most common genera. This rare disease primarily affects immunocompromised patients, with presentations ranging from rhino-orbito-cerebral infections to disseminated mucormycosis with angioinvasion, leading to thrombosis and tissue infarction. Gastrointestinal mucormycosis is the least common clinical presentation and is believed to be secondary to spore ingestion.

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Article Synopsis
  • Fungal rhino-orbital-cerebral infections are challenging to treat, especially in people with weakened immune systems, such as diabetics, and rarely involve bacterial co-infections.
  • A case study of a 74-year-old diabetic male revealed he had chronic mucormycosis, leading to symptoms like nasal congestion and confusion, with successful treatment achieved over 24 days.
  • While chronic mucormycosis is uncommon, it emphasizes the importance of thorough diagnostics and integrated treatment approaches, including surgery and antifungal therapies, for effective management.
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Objective: To describe clinicoradiological features and surgical outcomes in a series of nine patients with rhino-orbito-cerebral mucormycosis (ROCM) who presented with Pott's puffy tumor (ROCM-PPT).

Methods: The records of nine patients with ROCM-PPT seen between March 2020 and December 2021 were analysed. Clinical features, radiology, histopathology, operative findings, management and outcome were noted.

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Mucormycosis is a potentially fatal condition with a high mortality rate, particularly when there is extra nasal involvement, and it is rare for patients with fungal brain disease to survive. It mostly affects patients who are metabolically or immunologically compromised, which constitutes one of the three classical stages of the progression of Rhino-Orbito-Cerebral Mucormycosis (ROCM). Stage I: infection of the nasal mucosa and paranasal sinuses; Stage II: orbital involvement; Stage III: cerebral involvement.

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