Facial Nerve Palsy with Total Ophthalmoplegia; a NovelPresentation of Fungal Invasion

Mucormycosis is an expeditious invasion of a fungus of angioinvasive nature, predominant in immunocompro-mised individuals, often leading to organ malfunction and loss. Facial nerve involvement and total ophthalmo-plegia are its rare presentations. Early detection and treatment can alter natural disease course and prevent po-tential catastrophic outcomes in diabetic patients. Facial nerve palsy is mostly attributed to peripheral neuropa-thy in patients with advanced diabetes mellitus. It rarely raises alarm about an invasive fungal infection. Here,we report the case of a 38-year-old male with type 2 diabetes mellitus, who presented to us with left lower motorneuron type facial palsy and left-sided total ophthalmoplegia due to invasive rhino-orbito-cerebral mucormyco-sis (ROCM). Despite aggressive measures, including antifungal therapy and repeated endoscopic debridement,he subsequently developed central retinal artery occlusion (CRAO) and underwent left eye exenteration.