Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report

Basavaraj Tulajappa Badadal; Viraja Nimmagadda; Mallanna Mulimani; Mamatha Karigar; Savitri Nerune; Firos Khan

doi:doi:10.11648/j.ijn.20200402.17

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Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report

Basavaraj Tulajappa Badadal, Viraja Nimmagadda, Mallanna Mulimani, Mamatha Karigar, Savitri Nerune, Firos Khan

Published in International Journal of Neurosurgery (Volume 4, Issue 2)

Received: 29 August 2020 Accepted: 24 October 2020 Published: 23 November 2020

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Abstract

Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.

Published in	International Journal of Neurosurgery (Volume 4, Issue 2)
DOI	10.11648/j.ijn.20200402.17
Page(s)	59-62
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Central Nervous System Mucormycosis, Mucoraceae, Diabetic Ketoacidosis

References

[1]	Brad Spellberg, Ashraf S. Ibrahim. Mucormycosis. In: Jameson J. Larry et al, editors. Harrison’s Priciples Of internal medicine. 20^th ed. New York: McGraw-Hill Education; 2018. p. 1537-1541.
[2]	Malik AN, Bi WL, McCray B, Abedalthagafi M, Vaitkevicius H, Dunn IF. Isolated cerebral mucormycosis of the basal ganglia. Clinical neurology and neurosurgery. 2014 Sep; 124: 102.
[3]	Verma A, Brozman B, Petito CK. Isolated cerebral mucormycosis: report of a case and review of the literature. Journal of the neurological sciences. 2006 Jan 15; 240 (1-2): 65-9.
[4]	Gebremariam T, Liu M, Luo G, Bruno V, Phan QT, Waring AJ, Edwards JE, Filler SG, Yeaman MR, Ibrahim AS. CotH3 mediates fungal invasion of host cells during mucormycosis. The Journal of clinical investigation. 2014 Jan 2; 124 (1): 237-50.
[5]	Dhakar MB, Rayes M, Kupsky W, Tselis A, Norris G. A Cryptic Case: Isolated Cerebral Mucormycosis. The American journal of medicine. 2015 Dec 1; 128 (12): 1296-9.
[6]	Prakash, H.; Ghosh, A. K.; Rudramurthy, S. M.; Singh, P.; Xess, I.; Savio, J.; Pamidimukkala, U.; Jillwin, J.; Varma, S.; Das, A.; et al. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Medical Mycology. 2018, 57, 395–402.
[7]	Manesh, A.; Rupali, P.; Sullivan, M. O.; Mohanraj, P.; Rupa, V.; George, B.; Michael, J. S. Mucormycosis—A clinic epidemiological review of cases over 10 years. Mycoses 2019, 62, 391–398.
[8]	Kerezoudis, P.; Watts, C. R.; Bydon, M.; Dababneh, A. S.; Deyo, C. N.; Frye, J. M.; Kelley, P. C.; Kemp, A. M.; Palraj, B. V.; Pupillo, G. T. Diagnosis and Treatment of Isolated Cerebral Mucormycosis: Patient-Level Data Meta-Analysis and Mayo Clinic Experience. World Neurosurgery. 2019, 123, 425–434.
[9]	Hazama, A.; Galgano, M.; Fullmer, J.; Hall, W.; Chin, L. A_nity of Mucormycosis for Basal Ganglia in Intravenous Drug Users: Case Illustration and Review of Literature. World Neurosurgery. 2017, 98, 872. e1–872. e3.
[10]	Roden M. M., Zaoutis T. E., Buchanan W. L., Knudsen T. A., Sarkisova T. A., Schaufele R. L., Sein M., Sein T., Chiou C. C., Chu J. H., Kontoyiannis D. P. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clinical Infectious Diseases. 2005; 41 (5): 634–653. (Matched ISSN: 1058-4838).
[11]	Arakkal G, Kasetty HK, Damarla S, Chintagunta S. Mucormycosis: A rare case report. International Journal of Oral Health Sciences. 2014 Jan 1; 4 (1): 46.
[12]	Oladeji SM, Amusa YB, Olabanji JK, Adisa AO. Rhino cerebral mucormycosis in a diabetic case report. Journal of the West African College of Surgeons. 2013 Jan; 3 (1): 93.
[13]	Cheema SA, Amin F. Five cases of rhino cerebral mucormycosis. British Journal of Oral and Maxillofacial Surgery. 2007 Mar 1; 45 (2): 161-2.
[14]	Guinea, J.; Escribano, P.; Vena, A.; Munoz, P.; Martinez-Jimenez, M. D. C.; Padilla, B.; Bouza, E. Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: Epidemiology and microbiological characterization of the isolates. PLoS ONE 2017, 12, e0179136.

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APA Style

Basavaraj Tulajappa Badadal, Viraja Nimmagadda, Mallanna Mulimani, Mamatha Karigar, Savitri Nerune, et al. (2020). Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. International Journal of Neurosurgery, 4(2), 59-62. https://doi.org/10.11648/j.ijn.20200402.17

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ACS Style

Basavaraj Tulajappa Badadal; Viraja Nimmagadda; Mallanna Mulimani; Mamatha Karigar; Savitri Nerune, et al. Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. Int. J. Neurosurg. 2020, 4(2), 59-62. doi: 10.11648/j.ijn.20200402.17

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AMA Style

Basavaraj Tulajappa Badadal, Viraja Nimmagadda, Mallanna Mulimani, Mamatha Karigar, Savitri Nerune, et al. Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. Int J Neurosurg. 2020;4(2):59-62. doi: 10.11648/j.ijn.20200402.17

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@article{10.11648/j.ijn.20200402.17,
  author = {Basavaraj Tulajappa Badadal and Viraja Nimmagadda and Mallanna Mulimani and Mamatha Karigar and Savitri Nerune and Firos Khan},
  title = {Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {59-62},
  doi = {10.11648/j.ijn.20200402.17},
  url = {https://doi.org/10.11648/j.ijn.20200402.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.17},
  abstract = {Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.},
 year = {2020}
}

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TY  - JOUR
T1  - Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report
AU  - Basavaraj Tulajappa Badadal
AU  - Viraja Nimmagadda
AU  - Mallanna Mulimani
AU  - Mamatha Karigar
AU  - Savitri Nerune
AU  - Firos Khan
Y1  - 2020/11/23
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.17
DO  - 10.11648/j.ijn.20200402.17
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 59
EP  - 62
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.17
AB  - Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.
VL  - 4
IS  - 2
ER  -

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Author Information

Basavaraj Tulajappa Badadal

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India
Viraja Nimmagadda

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India
Mallanna Mulimani

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India
Mamatha Karigar

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India
Savitri Nerune

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India
Firos Khan

BLDE (Deemed to be University) Shri B M Patil Medical College and Research Centre, Vijayapur, Karnataka State, India

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APA Style

Basavaraj Tulajappa Badadal, Viraja Nimmagadda, Mallanna Mulimani, Mamatha Karigar, Savitri Nerune, et al. (2020). Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. International Journal of Neurosurgery, 4(2), 59-62. https://doi.org/10.11648/j.ijn.20200402.17

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ACS Style

Basavaraj Tulajappa Badadal; Viraja Nimmagadda; Mallanna Mulimani; Mamatha Karigar; Savitri Nerune, et al. Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. Int. J. Neurosurg. 2020, 4(2), 59-62. doi: 10.11648/j.ijn.20200402.17

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AMA Style

Basavaraj Tulajappa Badadal, Viraja Nimmagadda, Mallanna Mulimani, Mamatha Karigar, Savitri Nerune, et al. Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report. Int J Neurosurg. 2020;4(2):59-62. doi: 10.11648/j.ijn.20200402.17

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@article{10.11648/j.ijn.20200402.17,
  author = {Basavaraj Tulajappa Badadal and Viraja Nimmagadda and Mallanna Mulimani and Mamatha Karigar and Savitri Nerune and Firos Khan},
  title = {Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {59-62},
  doi = {10.11648/j.ijn.20200402.17},
  url = {https://doi.org/10.11648/j.ijn.20200402.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.17},
  abstract = {Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.},
 year = {2020}
}

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TY  - JOUR
T1  - Primary Central Nervous System Mucormycosis Mimicking Like a High Grade Glioma - A Rare Case Report
AU  - Basavaraj Tulajappa Badadal
AU  - Viraja Nimmagadda
AU  - Mallanna Mulimani
AU  - Mamatha Karigar
AU  - Savitri Nerune
AU  - Firos Khan
Y1  - 2020/11/23
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.17
DO  - 10.11648/j.ijn.20200402.17
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 59
EP  - 62
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.17
AB  - Mucormycosis is an invasive fungal infection caused by fungi of Mucoraceae family in immunocompromised individuals. CNS (Central Nervous System) Mucormycosis commonly arises from an adjacent para nasal sinus infection (Rhino cerebral), but isolated CNS Mucormycosis is a rare presentation as in our case. Presented as raised intra cranial pressure and no focal neurological deficit on evaluation found to have left temporal space occupying lesion with significant mass effect looking like high grade glioma. Operated on emergency basis, histopathology suggestive of invasive fungal infection managed accordingly. Results: As per literature primary CNS Mucormycosis has high mortality and morbidity even after best possible management. Our case was managed as per treatment protocol and after discharge patient got readmitted with surgical site infection and uncontrolled blood sugars and worsened medical condition, and finally died due to cardiac event after 28 days of diagnosis. Conclusion: Mucormycosis is an aggressive infection which can cause significant morbidity and mortality, thus needs high index of suspicion for early diagnosis and treatment.
VL  - 4
IS  - 2
ER  -

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