Mucormycosis creeping along the nerves in an immunocompetent individual

摘要

Mucormycosis is a rare opportunistic fungal infection, often life-threatening. We report an unusual case of rhinocerebral mucormycosis in an immunocompetent patient. A 23-year-old male presented with headache, speech disturbance and hearing difficulty for 4 weeks. Magnetic resonance imaging (MRI) revealed right cerebellar abscess and enhancing soft tissue in the nasal cavity, extending to cranial and infratemporal fossae. Computed tomography (CT) revealed the widening of foramen rotundum and sclerosis involving the sphenoid and ethmoid sinuses. MR Spectroscopy revealed multiple peaks between 3.6 and 3.8 parts per million (ppm) which could represent trehalose. Nasal mucosa scrapings confirmed mucormycosis. Suspicion of a fungal infection needs to be considered even in the absence of immunocompromised status.