• Cha Dong Yeo, Jong Seung Kim, Sam Hyun Kwon, Eun Jung Lee, Min Hee Lee, Su Geun Kim, Yeon Seok You, June Sun Kim, Jong Hwan Lee, and Ji Seob Ryu.
• Department of Otolaryngology-Head and Neck Surgery.
• Medicine (Baltimore). 2018 Dec 1; 97 (51): e13290.

RationaleMucormycosis is a rare fungal infection which mainly develops in compromised hosts and the associated mortality rate is high.Patient ConcernsWe report a case of mucormycosis in a 59-year-old woman following routine endoscopic sinus surgery. The patient had a history of diabetes mellitus (DM) and bronchial asthma.DiagnosesOn follow-up 4 weeks after the first functional endoscopic sinus surgery (FESS), she complained of a severe headache and was readmitted for a second period. Endoscopic examination revealed bony erosion and a whitish discharge on the left middle turbinate, which was confirmed as mucormycosis by endoscopic biopsy.InterventionsEndoscopic debridement of the necrotic tissue and middle turbinectomy were performed and the patient was treated with intravenous amphotericin B for 3 months (3.5 mg/kg/day).OutcomesAbout 1 month into the second period of hospitalization, left Bell's palsy had occurred. The facial palsy improved naturally after 2 months of hospitalization. One year after endoscopic debridement, follow-up endoscopy showed that there was no residual lesion.ConclusionThis is the first report of mucormycosis after routine endoscopic sinus surgery. We did not miss headache symptom after FESS surgery, and diagnosed mucormycosis through early endoscopic biopsy, which played an important role in curing the patient. In addition to the importance of medical therapy such as DM control for patients, emotional support and psychiatric treatment are also important factors as these patients require hospitalization for a long period, 3 months in the case of this patient.

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