case_images: PMC10852138_01
case_images: X-ray image on admission. Diagnosis: Normal cardiac configuration, both lung felids show increased bronchovascular markings; however, no detected pulmonary opacities and clear costophrenic angles
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case_images: Chest X-ray showed clear costophrenic angles [Figure 1], but brain computerized tomography scan with contrast concluded features of pansinusitis with left side facial and periorbital inflammatory process (cellulitis) with left proptosis but no evidence of cavernous sinus thrombosis.
case_images: MRI brain scan with contrast. Conclusion: A case of invasive sinonasal mucormycosis showing orbital and cerebral extension. Orbital involvement: Periorbital and orbital cellulitis as described. No intraorbital abscess formation. Intracranial involvement: Regional focal bilateral frontal lobe early cerebritis as described likely due to perineural spread along olfactory nerve root. No current evidence of intracerebral abscess formation. MRI: Magnetic resonance imaging
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case_images: Later during admission, brain magnetic resonance imaging (MRI) scan with contrast revealed invasive sinonasal mucormycosis with orbital and cerebral extension and intracranial involvement [Figure 2].
case_images: Ophthalmoplegia of both eyes, bilateral proptosis, and bilateral blindness
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case_images: The patient developed bilateral ophthalmoplegia, proptosis, and blindness, and necrotic eschar of the left ear [Figure 3].