Curvularia lunata Causing Orbital Cellulitis in a Diabetic Patient: An Old Fungus in a New Territory

Background and purpose: Rhinocerebral mycosis is a rapidly invasive infection in diabetic patients with an unfavorable course. Herein, we report a rare case of orbital cellulitis caused by Curvularia lunata following fungal rhinosinusitis in a diabetic male patient.

Case report: A 35-year-old male with uncontrolled diabetes presented to the emergency department of our center with high-grade fever accompanied by chills and rigors, severe diffuse headache, and projectile vomiting with swelling and loss of vision in the right eye. The tissue sample from surgical debridement showed pigmented hyphae; in addition, Curvularia lunata was isolated in culture. Imaging was indicative of orbital extension. Therefore, the patient was diagnosed with fungal rhinosinusitis with orbital cellulitis. The patient was subjected to extensive surgical debridement, along with antifungals. Rhinosinusitis resolved; however, the loss of vision was irreversible.

Conclusion: Orbital cellulitis is a very rare but life-threatening complication of fungal rhinosinusitis. Very few cases of orbital cellulitis following fungal rhinosinusitis have been reported in the literature. Early and prompt diagnosis can save the life of a patient.

Keywords: Curvularia; Diabetes mellitus; Fungal rhinosinusitis; Orbital Cellulitis.