Clinicopathologic study of 16 cases of rhino-orbitocerebral mucormycosis

Abstract

Abstract: Objective To characterize clinicopathologic features of rhino-orbitocerebral mucormycosis (ROCM).Methods Sixteen cases of ROCM diagnosed in Beijing Tongren Hospital from 1998 to 2008 were studied retrospectively.HE,PAS and GMS stains were performed on all the paraffin-embedded tissues,one of which was also observed by transmission electron microscope.Results Fourteen patients (87.5%) had underlying conditions.The mortality was 31.3% (5 cases),including 3 patients died of ROCM and 2 died of primary diseases.Orbital (n=15) and cerebral (n=5) involvements were observed by CT and MRI.Fungal culture showed positive results in 7 cases.Pathological examination showed coagulation necrosis,fungal vasculitis and formations of granuloma in all cases,bone destructions in 9 cases and peripheral nerve fiber necrosis in 7 cases.Hyphae with high electron density and irregular shape distributed in the necrotic tissue were found under electron microscopy.Conclusions ROCM mainly occurs in immunocompromised patients,such as DM or hematological malignancies.Rhizopus and Mucor are the major pathogens.Diagnosis depends on the characteristic hyphae of Mucorales found in the lesions,combined with clinical manifestation,radiologly,laboratory and histopathologly.

Key words: rhino-orbitocerebral mucormycosis, clinic, pathology

CLC Number:

R756.6

LI Li-li, LIU Hong-gang, PIAO Ying-shi, HE Chun-yan, ZHOU Quan, ZHANG Yang, ZHAO Zuo-tao. Clinicopathologic study of 16 cases of rhino-orbitocerebral mucormycosis[J]. Chinese Journal of Mycology, 2010, 5(2): 74-77,115.

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