An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 13 , ISSUE 2 ( May-August, 2021 ) > List of Articles

CASE REPORT

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

Kanika Arora, Balaji Ramamourthy, Satyawati Mohindra

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

Citation Information : Arora K, 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

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


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.


PDF Share
  1. Viterbo S, Fasolis M, Garzino-Demo P, et al. Management and outcomes of three cases of rhinocerebralmucormycosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(6):69–74. DOI: 10.1016/j.tripleo.2011.04.048.
  2. Pinto ME, Manrique HA, Guevara X, et al. Hyperglycemic hyperosmolar state and rhino-orbital mucormycosis. Diabetes Res Clin Pract 2011;91(2):37–39. DOI: 10.1016/j.diabres.2010.09.038.
  3. Chole RA, Donald PJ. Petrous apicitis: clinical considerations. Ann Otol Rhinol Laryngol 1983;92:544–551. DOI: 10.1177/000348948309200603.
  4. Katsantonis NG, Hunter JB, O'Connell BP, et al. Temporal bone mucormycosis. Ann Otol Rhinol Laryngol 2016;125(10):850–853. DOI: 10.1177/0003489416654711.
  5. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005;41(5):634–653. DOI: 10.1086/432579.
  6. Yun MW, Lui CC, Chen WJ. Facial paralysis secondary to tympanic mucormycosis: case report. Am J Otol 1994;15(3):413–414. PMID: 8579151.
  7. Macdonell RA, Donnan GA, Kalnins RM, et al. Otocerebral mucormycosis: a case report. Clin Exp Neurol 1987;23:225–232. PMID: 3665174.
  8. Hazarika P, Zachariah J, Victor J, et al. Mucormycosis of the middle ear: a case report with review of literature. Indian J Otolaryngol Head Neck Surg 2012;64(1):90–94. DOI: 10.1007/s12070-011-0156-3.
  9. Petrenko O, Alkayali T, Ramos B, et al. Invasive rhinocerebral mucormycosis leading to gradenigo's syndrome in type 1 diabetic. Endocr Pract 2019;144.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.