Rhino-Orbital-Cerebral Mucormycosis Presenting as Cavernous Sinus Thrombosis with Ocular Ischemic Syndrome and Contralateral Central Retinal Artery Occlusion: A Case Report

Rhino-orbital cerebral mucormycosis（ROCM）is a rare infection that can progress into cavernous sinus thrombosis（CST）, a life-threatening ocular emergency with significant systemic consequences. Herein, we present the case of a 57-year-old female diabetes patient came to the emergency room with bilateral blurred vision. Two weeks prior, she had experienced a right upper maxillary gingival abscess, fever, general weakness, and headache. The patient was somnolent and exhibited a Harlequin-face, with no light perception bilaterally. Ptosis, proptosis, conjunctival chemosis, and corneal ulcers were prominent in the right eye, while the left eye showed a cherry-red spot fundus appearance. Contrast-enhanced brain magnetic resonance imaging revealed sinusitis, a right CST, and a dilated superior ophthalmic vein. Sinus biopsy cultures revealed Rhizopus sp.. Dental/sinus infections due to mucormycosis can potentially progress to ROCM, especially in diabetic patients with ketosis or ketoacidosis, who have a significant risk of morbidity and mortality from a rapidly deteriorating process.