Invasive Rhinocerebral Mycosis: A report of three cases from India

Rhinocerebral mycosis is a rapidly progressive fatal opportunistic infection and is increasingly being recognized these days. Aspergillosis and zygomycosis are predominantly responsible for rhinocerebral mycosis. Here we are presenting three cases of rhinocerebral mycosis- two cases of rhinocerebral mucormycosis and one case of rhinocerebral aspergillosis. Diagnosis is established presumptively from fungal culture of sinus or nasal material and tissue biopsy for histopathological examination. MRI brain was done in all the three cases which showed extension of disease in the cavernous sinus (case 1), orbit and peri-orbital region (case 2) and frontal lobe (case 3). Amphotericin B was initiated in all the cases, while surgical debridement was done in the 3rd case. However two out of three cases were succumbed to their illness after 10-12 days of admission, suggesting high mortality in such cases.