Rhino-Orbito-Cerebral Mucormycosis:Two Cases and Literature Review
YANG Fei
ZHANG Shuguang
LI Hongqiang
ZHANG Xiaojuan
LIU Huan
SUN Limin
WANG Zhenhua
SUN Tongwen
Abstract：Objective To understand the clinical characteristics of rhin-orbital-cerebral mucormycosis(ROCM)and improve clinicians' understanding of the disease.Methods The clinical manifestations,laboratory test results,treatment and outcome were reviewed and analyzed in 2 patients with ROCM.PubMed database was searched using the strategy of"Rhizopus oryzae"and"mycosis"or"mucormycosis"or"rhino-orbital cerebral mucormycosis"or"rhino mucormycosis"or"cerebral mucormycosis"or"ophthalmic mucormycosis"from 1947 to 2023 to find out the literatures with ROCM.The clinical data of the ROCM patients were identified,analyzed and summarized.Results Both patients in this report had diabetes.Metagenomic next-generation sequencing(mNGS)showed early indication of Rhizopus oryzae infection,and the diagnosis was confirmed through histopathology.Both patients were treated with debridement and amphotericin B liposome.One case died of intracranial hemorrhage 12 hours after debridement,and the other one was still alive after half a year of follow-up.Through literature review and combining these 2 patients,a total of 47 patients were collected,including 26 males and 21 females,aged 3-78 years old.35 patients(74.4％)were complicated with diabetes mellitus,of which 22 cases(62.8％)were diabetic ketoacidosis,38 patients received intravenous amphotericin B/liposome,surgical intervention was performed in 24 cases.The diagnosis was confirmed through histopathology,secretion culture,mNGS,etc,13 cases were cured,and 34 cases died,with a mortality rate of 72.3％,22 patients were given intravenous infusion of amphotericin B/liposome and surgical debridement at the same time,and the mortality rate was 54.5％.Conclusion Diabetes is the main causative factor of ROCM,and most patients have ketoacidosis.The use of mNGS helps in early diagnosis,and early surgical debridement and targeted treatment can improve the prognosis of patients.
Keywords：rhino-orbital-cerebral mucormycosisRhizopus oryzaemetagenomic sequencing
Publication Date：2025-10-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 3467-3473 )