Abstract
Introduction: Mucormycosis is a rare and life-threatening fungal infection that usually affects immunocompromised patients. The most frequent anatomical locations are pulmonary and rhino-orbito-cerebral ones. Others ENT and cervico-facial locations are rare. We propose to present an exceptional case of a cervical lymph node mucormycosis associated with mediastinitis and to study clinical, therapeutic and prognostic aspects.
Observation: It was a 50-year-old woman, with a history of decompensate type 2 diabetes, who presented to ENT emergency with a painful left latero-cervical swelling evolving for 4 days. Further examinations revealed a mucormycosis cervical adenophlegmon complicated by a necrotizing fasciitis of the neck and mediastinitis. Both surgical debridement of necrotic tissue and systemic anti-fungal therapy were prescribed and the patient was admitted in an intensive unit care. The evolution was unfavorable with a cascade of complications: nosocomial surinfection; renal failure as a side effect of the anti-fungal therapy and death in a septic shock.
Conclusion: Mucormycosis is a rare fungal infection with a high morbidity and mortality despite the antifungal treatments progress. It typically involves the rhino-cerebral and pulmonary areas. The involvement of the cervical lymph nodes and the mediastina is rare. The identification of risk factors is necessary to reduce the incidence of mucomycosis and a multidisciplinary approach is essential for prompt diagnosis and management
Key words: Mucormycosis, Head and neck, Epidemiology, Diagnosis, Treatment, Prognosis
