Rhinocerebral mucormycosis in IDDM Sequential magnetic resonance imaging of long-term survival with intensive therapy

George W. Moll, Frank A. Raila, Gilbert C. Liu, A. Wallace Conerly

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE- To describe the clinical course and the utility of computerized tomography (CT) and magnetic resonance imaging (MRI) in the successful management of an often fatal fungal infection in a 12-year-old patient with insulin-dependent diabetes mellitus (IDDM). CASE- The patient was admitted to The University of Mississippi Medical Center (UMC) for the purpose of diabetic ketoacidosis (DKA) management and subsequent intensive therapy for mucormycosis according to nationally accepted standards of care. Strict diabetic control was instituted with frequent monitoring of blood glucose levels and interval assessment of HbA1c. Sequential MRI studies were obtained according to approved patient standards; the clinical and MRI course of the infection was charted. RESULTS- The patient's DKA resolved within 12 h on intravenous fluid repletion and insulin therapy. His sinusitis/rhinitis noted on admission did not respond to intravenous antibiotic therapy and progressed with obvious left orbital involvement and left cranial nerve palsies by 72 h of hospitalization. CT and MRI were invaluable aids to the early diagnosis and design of appropriate surgical and antifungal management of this patient, who survived with minimal left cranial nerve palsies. CONCLUSIONS- Our patient is among the youngest of IDDM patients reported to have survived rhinocerebral mucormycosis. His survival is attributed to early recognition of possible mucormycosis with diagnostic support of CT and MRI, surgical debridement and antifungal therapy, and intensive blood glucose control. Sequential MRI is invaluable to the design of therapy for this type of patient and shows the nearly 3-year recovery from mucormycosis.

Original languageEnglish (US)
Pages (from-to)1348-1353
Number of pages6
JournalDiabetes Care
Volume17
Issue number11
StatePublished - Nov 1994
Externally publishedYes

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Mucormycosis
Type 1 Diabetes Mellitus
Magnetic Resonance Imaging
Survival
Cranial Nerve Diseases
Diabetic Ketoacidosis
Tomography
Therapeutics
Blood Glucose
Mississippi
Mycoses
Sinusitis
Debridement
Standard of Care
Rhinitis
Early Diagnosis
Hospitalization
Insulin
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Moll, G. W., Raila, F. A., Liu, G. C., & Conerly, A. W. (1994). Rhinocerebral mucormycosis in IDDM Sequential magnetic resonance imaging of long-term survival with intensive therapy. Diabetes Care, 17(11), 1348-1353.

Rhinocerebral mucormycosis in IDDM Sequential magnetic resonance imaging of long-term survival with intensive therapy. / Moll, George W.; Raila, Frank A.; Liu, Gilbert C.; Conerly, A. Wallace.

In: Diabetes Care, Vol. 17, No. 11, 11.1994, p. 1348-1353.

Research output: Contribution to journalArticle

Moll, George W. ; Raila, Frank A. ; Liu, Gilbert C. ; Conerly, A. Wallace. / Rhinocerebral mucormycosis in IDDM Sequential magnetic resonance imaging of long-term survival with intensive therapy. In: Diabetes Care. 1994 ; Vol. 17, No. 11. pp. 1348-1353.
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