How does mucormycosis present?
• Most cases involve the paranasal sinuses , spreading rapidly to the brain. This “rhinocerebral” mucormycosis is the commonest presentation, often in the context of poorly-controlled diabetes. Survival with intracerebral abscess is rare. Occasionally a slowly progressive “chronic rhinocerebral mucormycosis” is seen, gradually worsening over several months, and more commonly associated with internal carotid artery or cavernous sinus thrombosis than is the acute form. The “orbital apex syndrome” in the absence of orbital cellulitis (due to a localised inflammatory fungal mass) has occasionally been reported. A few cases have had infection confined to the brain. Other sites include: • The lung; • skin and subcutaneous tissue; • rarely, the kidney or gastrointestinal tract; • It may even be disseminated, often only diagnosed post-mortem. Many classify skin infections separately, as ‘entomophthoromycosis’. The phycomycete Basidiobolus microsporus is often implicated in this unpronounceable
