METHODS: A 51-year-old Persian housewife with a history of poorly controlled diabetes mellitus presented with a splitting headache that had been ongoing for 1 week and an inability to close her left eye or make facial expressions on the left side of her face. The patient\'s vital signs were normal, but physical examination revealed a yellow-grey scar on the left side of her hard palate and Bell\'s palsy on the left side. A neurological examination showed that she could move both eyes but could not close her left eye, move up her left eyebrow, or smile. Further investigations were performed, including laboratory tests, radiologic imaging, and functional endoscopic sinus surgery. The patient underwent three rounds of debridement for bony erosion in the medial and posterior walls of the left maxillary sinus and the hard palate. Pathological examination confirmed mucormycosis infection in the hard palate and mucosa.
CONCLUSIONS: Fungal infection must be considered a potential diagnosis for immunocompromised adults who exhibit symptoms of Bell\'s palsy.
方法:一名51岁的波斯家庭主妇,糖尿病控制不佳,表现为头痛欲裂,持续1周,无法关闭左眼或面部左侧的面部表情。病人的生命体征正常,但体格检查显示,她的硬腭左侧有黄灰色疤痕,左侧有贝尔麻痹。神经系统检查显示,她可以移动双眼,但无法关闭左眼,向上移动她的左眉毛,或者微笑。进行了进一步的调查,包括实验室测试,放射学成像,和功能性内窥镜鼻窦手术。患者接受了三轮清创术,以治疗左上颌窦和硬腭的内壁和后壁的骨侵蚀。病理检查证实硬腭和粘膜的毛霉菌病感染。
结论:真菌感染必须被认为是表现出贝尔麻痹症状的免疫受损成人的潜在诊断。