PMC8326607_01
(a) Initial findings at diagnosis: oedema on the right side of the face. (b) Three days after the first intervention: regression of orbital edema with loss of suborbital skin substance.
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She had edema on the right side of the face (Figure 1(a)). After 3 days, diffuse swelling on the right side of the face has been observed together with large ulceration in the infra-orbital region, progressive loss of consciousness and left hemiparesis (Figure 1(b)).
Findings in the CT scan of brain and paranasal sinuses: right ethmoid and maxillary sinus involvement with extension into the inferior wall of right orbit with osteolysis of the lateral and medial walls of the maxillary sinus. The brain parenchyma was normal.
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It was suggestive of sinusitis involving right ethmoid and maxillary sinus extending into the inferior wall of right orbit (Figure 2).
Findings in the CT scan of the brain: right temporal intracranial collection with right cavernous sinus thrombosis.
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A second brain CT scan with contrast was ordered and showed, in addition to lesions previously described a right temporal intracranial collection with enhancing wall measuring 10 mm x 23 mm x 12 mm and right cavernous sinus thrombosis (Figure 3).
(a) Broad non-septate hyphae branching at 90 degrees (hematoxylin and eosin x400). (b) Mucormycosis organisms highlighted with periodic acid-Schiff (PAS) stain.
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Histopathologic results from tissues retrieved during extensive sinus debridement revealed, staining large non-septate hyphae branching with the hematoxylin and eosin and highlighted with periodic acid-Schiff stain which corroborated the diagnosis of mucormycosis (Figure 4).
Patient 3 months after surgery.
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Three months later, the patient was in good general condition, without signs of active infection (Figure 5) and is currently on a plan to undergo facial plastic surgery.