Bilateral cavernous sinus thrombosis due to mucormycosis

E. Van Johnson, L. B. Kline, B. A. Julian and J. H. Garcia
Combined Program in Ophthalmology, Eye Foundation Hospital, Birmingham, AL.

A 49-year-old man requiring hemodialysis for end-stage renal disease developed orbital cellulitis and bilateral central retinal artery occlusions. Although cranial computed tomography demonstrated ethmoid and sphenoid sinusitis, two surgical biopsy specimens of sinus mucosa were nondiagnostic. Autopsy findings confirmed cerebral mucormycosis with bilateral cavernous sinus and carotid artery thrombosis. The patient had been taking deferoxamine for hemochromatosis, and this chelating agent may have been the predisposing factor in developing mucormycosis. We discuss the limitations of current neuroimaging techniques in establishing the diagnosis of both cerebral mucormycosis and cavernous sinus thrombosis.