case_images: PMC11343495_01
case_images: a-22-year-old male with two big ulcers at the right medial canthus and right periauricular area; multiple fistulas present at right zygomatic and maxillary area; severe proptosis with prolapse of ocular content was observed on the right eye
case_images: PAMJ-48-13-g001.jpg
case_images: PMC11343495_01_PAMJ-48-13-g001.jpg
case_images: F1
case_images: The content of the eyeball was already prolapsed (Figure 1).
case_images: A) head CT scan with contrast, axial slice showed proptosis of the right eye 2.9 cm from interzygomatic line; solid mass was seen in the right retrobulbar, filling intraconal and extraconal area, with heterogenous contrast enhancement; this mass initially raising suspicion of malignancy; B) coronal slices showed thickening of the right extraocular muscles indicating chronic myositis
case_images: PAMJ-48-13-g002.jpg
case_images: PMC11343495_01_PAMJ-48-13-g002.jpg
case_images: F2
case_images: Hepatitis B and C, autoimmune disease screening, Tuberculosis GenXpert testing were unremarkable. Head CT-scan with contrast confirming orbital cellulitis and proptosis of the right ocular bulb approximately 2.9 cm to the inferolateral side with cutan-subcutaneous abscess formation (Figure 2).
case_images: exenteration and surgical debridement of the frontal and zygoma subcutaneous abscess
case_images: PAMJ-48-13-g003.jpg
case_images: PMC11343495_01_PAMJ-48-13-g003.jpg
case_images: F3
case_images: Debridement surgery with a Weber-Fergusson technique and exenteration of the right orbital tissue was carried out on day 20th of admission (Figure 3).
case_images: A) periodic acid Schiff staining revealed ribbon-like hyphae with pauciseptate (arrow); B) some of the hyphae with 90  branching identified as mucor sp (arrow)
case_images: PAMJ-48-13-g004.jpg
case_images: PMC11343495_01_PAMJ-48-13-g004.jpg
case_images: F4
case_images: Periodic acid Schiff staining revealed ribbon-like hyphae with pauciseptate, some of the hyphae with 90  branching identified as mucoraceae family (Figure 4).
case_images: follow-up six months after treatment; the exenterated socket has epithelialized, but the fistula to the maxillary sinus is still present; an orbital prosthesis has been proposed and will be implemented in the near future
case_images: PAMJ-48-13-g005.jpg
case_images: PMC11343495_01_PAMJ-48-13-g005.jpg
case_images: F5