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Rare disease
CASE REPORT
Eye for an eye: near-fatal outcome of fungal infection in a young, diabetic girl
  1. Fedja I Vos1,
  2. Sietze Reitsma2,
  3. Gwijde F J P M Adriaensen2,
  4. Wytske J Fokkens2
  1. 1 Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
  2. 2 Department of Otolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Fedja I Vos, fi.vos{at}vumc.nl

Summary

In this report, we describe the case of a young, diabetic girl with ketoacidosis who suffered sudden loss of vision of the right eye. The loss of vision was caused by an invasive rhino-orbital-cerebral fungal infection (mucormycosis) with extensive periorbital thrombosis. Despite maximal antifungal and surgical treatment (including exenteration of the right orbit), the clinical situation deteriorated. It was only after overcoming the difficulties of managing her hyperglycaemia that the patient’s condition stabilised and her life was saved. Another factor contributing to this girls’ survival was the swift diagnosis of mucormycosis, which was made soon after the onset of symptoms. Because of this, treatment could be started almost immediately.

  • ear, nose and throat/otolaryngology
  • metabolic disorders
  • infectious diseases
  • ophthalmology

https://doi.org/10.1136/bcr-2017-223059

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    Footnotes

    • Contributors All authors substantially contributed to the conception and design of the work, the acquisition, analysis or interpretation of data; drafting the work or revising it critically for important intellectual content; final approval of the version published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests Icmje-forms have been signed by all authors.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.