Mucormycotic skull base osteomyelitis: A case report

Mucormycotic skull base osteomyelitis in immunocompetent individuals is extremely rare clinical entity, with only 8 cases reported in literature till date. It is the most acute, fulminant and deadly infection most commonly seen arising from sinonasal tract and middle ear infections. The involvement of the bone is lately seen due to angioinvasiness nature of this opportunistic fungi infection. When seen in immunosuppressed individuals it can be more aggressive and can spread extensively to the deep facial structures, orbits and intracranially with erosion of the skull base and cervical vertebrae.Early diagnosis and prompt treatment planning for this malignant behavior type of infection is to reduce the mortality rate. We report a rare case of 61-year-old male patient complaining of cranial neuropathy of maxillary branch of trigeminal nerve from 22 days. Magnetic resonance imaging revealed radiodense lining of the right sphenoidal sinus with a lesion in infratemporal region provisionally diagnosed as meningioma. We performed surgical excision of the lesion with zygomatic arch access osteotomy. Histopathological examination revealed mucormycotic skull base osteomyelitis. Patient was started on amphotericin B therapy immediately.