Acute orbital mucormycosis. Report of two cases.

The syndrome of acute orbital mucormycosis, characterized by uncontrolled diabetes, unilateral internal and external ophthalmoplegia, proptosis, meningoencephalitis and rapid death, was first reported by Gregory et al. in 1943. 10 Since their report of 3 cases, 23 similar cases have appeared in the literature. 2-19,21 * The disease has occurred in the presence of diabetes (23 cases), cirrhosis (1 case), nephrosis (1 case), and diarrhea and dehydration (1 case). The disease is caused by ubiquitous, ordinarily saprophytic, nonseptate fungi comprising the class Phycomycetes and order Mucorales. The fungus infection apparently begins in the nose and spreads rapidly into the paranasal sinuses, orbit, and central nervous system. Mucorthrombosis of the regional arterial supply produces ischemic necrosis of the nasal, sinus, orbital, and brain tissues. The patients usually die within 2 weeks after the onset of their disease. Because of the rarity of this syndrome, and because of interesting therapeutic, diagnostic, and pathologic