Posters

Rhino-orbital mucormycosis: diagnosis with a 20 diopter lens and smartphone

Poster Details

First Author: V.Menna Barreto BRAZIL

Co Author(s):    P. Menna Barreto   R. Menna Barreto   R. Morschbacher   R. Bruno   E. Cunha   M. Vilela     

Abstract Details

Purpose:

To describe a clinical case o rhino-orbital mucormycosis with presented central retinal arterial occlusion, focusing on it's history, method of capturing the retinal image and the importance of a precocious diagnosis.

Setting:

Irmandade Santa Casa de Misericórdia de Porto Alegre hospital, Porto Alegre, Brazil

Methods:

Female, 55 years old, underwent kidney transplantation two years before. Came to emergency complaining of pain and loss of vision in the right eye (RE) during the previous week. Visual Acuity was light perception in right eye and 20/20(1.0) in the left. Presence of anisocoria and mydriasis in the RE. No findings in the cranial-MRI. In the following day, she iniciated with ptosis. The emergency doctor did a fundus examination with his smartphone and a 20-diopter lens and send the image to the ophthalmologist, who diagnosed central retinal arterial occlusion. The patient had a computed tomography of the orbit taken.

Results:

The CT showed a mass in the orbital apex. Amphotericin B was prescribed to the patient. She had a debridment surgical procedure of the lesion done, which was necrosed. The mycological exam showed mucormycosis infection and the drug was continued. The vascular and nerve components of the right orbit were involved. Nowadays, she is light perception, has a normal eyelid opening and has the muscular movements of the right eye preserved, except the inferior and lateral retus.

Conclusions:

Rhino-orbital-cerebral mucormycosis is an infection by the Mucorales species. These fungal spores are ubiquitous in the atmosphere and their inhalation leads to nasal passage infection. It has huge mortality rate, but the new recent therapies are providing better cure chances. It's very important a precocious diagnosis and, in this case, the possibility of doing an ocular retinal exam with a cell-phone and a 20-diopter lens has helped a lot. This new low cost method of capturing retinal images should be spread because it has a big potential of sieving systemic diseases.

Financial Disclosure:

None