PMC9126225_01
Tissue necrosis with the formation of black eschar over the skin overlying orbit associated with proptosis, conjunctival hyperemia, chemosis, and matted eyelashes.
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On the fourth DOA, rhino-orbital mucormycosis (see Figure 1) was considered and liposomal amphotericin B (5mg/kg/day IV) was started and ceftriaxone-sulbactam changed to meropenem 1g IV TID.
Brain MRI showing right frontal lobe cortical water shade zone, right thalamic, right midbrain, medial temporal lobe (leftward and center), and medial occipital lobes (rightward) cortical based T2 hyperintense and restricting lesions suggesting acute ischemic infarction.
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At the same time, a brain MRI was done (see Figures 2 and 3), and the finding is shown in the figure caption as reported by a body and neuroradiology subspecialist.
Brain MRI showing right eye proptosis and having an oval ocular shape possibly suggesting orbital cellulitis to r/o endophthalmitis (left, (A)) and bilateral ethmoid, left maxillary, and bilateral sphenoid sinuses mucosal thickening having T2 hypointense signal content along with the ischemic infarction finding above suggest invasive fungal sinusitis (right, (B)).
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At the same time, a brain MRI was done (see Figures 2 and 3), and the finding is shown in the figure caption as reported by a body and neuroradiology subspecialist.