A 46-year-old male who came to the emergency room of the Xoco General Hospital of the Federal District, Mexico, complaining of pain and increased volume in the left upper quadrant for 5 days secondary to dental extraction of first molar.
Upon admission, the patient presented difficulties in opening the mouth and ptosis, painful symptoms, malaise with inconsistent, disoriented language and psychomotor agitation.
The patient was admitted to the Intensive Care Unit (ICU), with severe electrolyte imbalance and acid-base imbalance and metabolic acidosis.
Empirical antimicrobial therapy was initiated with ceftriaxone and metronidazole, in addition to the treatment established for the underlying diseases.
The initial computed tomography (CT) showed the presence of segmental corticosubcortical infarcts in branches of the left middle cerebral artery (MCA) with a high possibility of developing brain abscess due to septic facial emboli.
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We performed incision and drainage of abscess, culture and antibiogram, with the finding of left palatal necrosis limited in the midline.
During the surgical procedure, part of the skin of the genian region is debrided, leaving a bloody area.
The patient was treated with total hypotonia of the left eye and total opacity of the cornea. The patient underwent left heminucleectomy and underwent diagnostic impression of mucormycosis.
Perform daily surgical procedures obtaining peaceful exposure.
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On the 15th day he was in awake ICU, Glasgow 11; he had simple commands and spontaneous ventilation.
The results of the culture taken in the first intervention are obtained with Mucor, Aspergilo and Pseudomona cream.
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After more than 3 weeks of hospital stay, the patient deteriorates until death.
The death diagnosis is established as: parenchymal hemorrhage, cerebral infarction in ACMI and severe sepsis secondary to rhinocerebral mucormycosis.
