A fatal case of acute bilateral orbital apex syndrome with mucormycosis

We report a fatal case of mucormycosis that started with an acute bilateral orbital apex syndrome. A 44-year-old man with severe alcoholic hepatitis visited our hospital with a chief complaint of sudden visual loss in his left eye. The cranial computed tomography scan and magnetic resonance imaging revealed a lesion in his left orbital apex. After being diagnosed with orbital apex syndrome due to infection, he was prescribed antibiotic and antifungal therapy. Despite the treatment, he showed no improvement, and he lost vision in the contralateral eye. He also developed cranial nerve symptoms. His general condition worsened rapidly; within a week, he died of multiple organ failure. Pathologic examination confirmed the diagnosis of invasive mucormycosis.