Akram Abdollahi - Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Tahereh shokohi - Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran / Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
Nasrin Amirrajab - Department of Medical Laboratory Sciences, School of Paramedicine/Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Mehdi Nikkhah - Department of Otolaryngology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Maryam Ghasemi - Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Laleh Vahedi Larijani - Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Mojtaba Didehdar - Department of Medical Mycology and Parasitology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
Zahra Seifi - Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Nahid gholinejad - Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Macit ilkit - Division of Mycology, Department of Microbiology, School of Medicine, University of Çukurova, Adana, Turkey

Background and Purpose: Rhino-orbito-cerebral mucormycosis (ROCM) is a rare disease with acute and fulminant manifestation. This infection is associated with high morbidity and mortality rates. Herein, we reviewed the manifestations, underlying conditions, medical treatments, and surgical interventions in ROCM patients admitted to a tertiary referral center in northern Iran over a seven-year period. Materials and Methods: In a retrospective analysis, ۱۵ cases of ROCM were identified from ۲۰۰۷ to ۲۰۱۳ in Bu Ali Sina Hospital, Sari, Iran. All the ROCM cases were clinically diagnosed and confirmed by histopathological and/or mycological examination. The relevant demographic data, clinical, ophthalmic, and neurologic manifestations, underlying conditions, medical treatments, and surgical interventions were recorded and analyzed. Results: The mean age of the patients was ۵۴±۱۱ years (age range: ۲۸–۷۰ years); ۲۶.۷% of the patients were male and ۷۳.۳% female (male: female ratio of ۱: ۲.۷). Uncontrolled diabetes was noted in at least ۸۶.۷% (۱۳/۱۵) of the cases. The maxillary sinuses were the most frequently involved sites (۶۶.۷% of the cases) followed by the ethmoid sinus. Amphotericin B in combination with surgical debridement was used in the treatment of ۸۰% of the cases. Furthermore,۷۳.۳% of the patients who were diagnosed early and underwent medical and extensive surgical debridement of the infected tissues survived. Conclusion: Uncontrolled diabetes mellitus is considered to be the main predisposing factor for ROCM. To prevent and reduce mortality rate of this acute disease, early diagnosis based on clinical findings and biopsy is recommended.

Diabetes, Iran, Rhino-orbito-cerebral mucormycosis, ROCM, Zygomycosis