Sawsan I Algabree.
Rhino-orbital Mucor Mycosis in severe malnutrition.
Infect Dis J Jan ;14(2):57-9.

A four year old child, presented with the sole complaint of high-grade fever for the past two days. On examination the child was severely wasted and pale. He did not have any obvious dysmorphic features. His weight was 8 kilogram; height was 81cm. weight for height on – 4standerd deviation (Zscore), mid arm circumference (10) cm. His examination was normal. He was admitted to the ward for management of severe malnutrition. Two days later, he developed redness of the skin over the right infra-orbital region and cheek, which progressed to peri-orbital edema and facial swelling with signs of orbital cellulitis. Right sided proptosis and ophthalmplagia developed subsequently. Examination of the palate and nose revealed cheesy material on nasal turbinate, septum and palate. CT scan showed a retro-orbital mass. Biopsy was taken from the involved area of the palate which showed large foci of necrosis and granuloma formation with giant cells and abundant non-septate hyphae of irregular width, branching at right angle. Based on biopsy report, a diagnosis of rhino-orbital mucormycosis was made and the child was started on intravenous infusion of amphotericin B, in addition to nutitrional therapeutic milk F100, multivitamins and antibiotics.

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