Rhinocerebral Mucormycosis with Petrositis Presenting with Gradenigo's Triad: A Diagnostic Dilemma

Balaji Ramamourthy; Satyawati Mohindra

doi:10.5005/jp-journals-10003-1370

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Rhinocerebral Mucormycosis with Petrositis Presenting with Gradenigo's Triad: A Diagnostic Dilemma

Balaji Ramamourthy, Satyawati Mohindra

Keywords : Diplopia, Fungal petrositis, Gradenigo's triad, Mucormycosis, Ptosis

Citation Information : Ramamourthy B, Mohindra S. Rhinocerebral Mucormycosis with Petrositis Presenting with Gradenigo's Triad: A Diagnostic Dilemma. Int J Otorhinolaryngol Clin 2021; 13 (2):40-42.

DOI: 10.5005/jp-journals-10003-1370

License: CC BY-NC 4.0

Published Online: 20-11-2021

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Abstract

Aim and objective: To report a rare case of fungal rhinosinusitis with Gradenigo's syndrome as the presenting feature. Background: Fungal petrositis has been sparingly reported with Aspergillus and Mucor secondary only to infection of mastoid part of temporal bone or intracranial extension. Case description: We report a case of a 50-year-old diabetic male who presented with classical Gradenigo's triad for 3 months duration without any associated nasal complaints and was thereby treated on lines of complicated chronic otitis media (COM). Failure to respond to conventional treatment, diagnostic nasal endoscopy and histopathology helped in establishing the diagnosis of mucormycosis and plan effective treatment. Conclusion: A chronic history suggestive of ear disease and absence of nasal symptoms should not rule out the possibility of mucormycosis, especially in an immunocompromised host. Clinical significance: Rhino-orbital variant can have petrous apex involvement as a complication and in cases where management of COM on conventional lines does not cause improvement of petrositis, fungal etiology should be considered.

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