CLINICAL SIGNS OF ORBITAL ISCHEMIA IN RHINO-ORBITOCEREBRAL MUCORMYCOSIS

Mucormycosis is the most acutely fatal fungus infection of man (Ferry and Abedi).1 The most common clinical type of infection is rhino-orbit ocerebral mucormycosis. Prompt recognition of the clinical picture is essential if the appropriate urgent management is to be instituted wit hout delay. The presence of black eschar in the region of the nasal pa ssages, palate, midface, and orbit is the best-recognized clinical sig n alerting the clinician to the diagnosis. Black eschar is, however, a feature in only a minority of these patients at the time of presentat ion. This paper discusses other clinical signs, particularly orbital i schemia, which should suggest the diagnosis. The clinical presentation of orbital ischemia in mucormycosis includes proptosis, total externa l and internal ophthalmoplegia, and early blindless. A lax, nontender periorbital puffiness, which does not feel warm to the examiner's touc h, is typical. Proptosis and chemosis, if present, are mild. These sig ns are compared with those of pyogenic orbital cellulitis, with which the condition might most easily be confused.