It remains nonpathogenic except in patients with diabetic ketoacidosis in whom rhinocerebral form may develop. Like aspergillosis there is a strong tendancy to involve blood vessels. Rhinocerebral mucormycosis begins in the paranasal sinuses, may extend locally into the orbit with eye pain, facial and periorbital swelling and ext opthalmoplegia and proptosis and loss of vision secondary to central artery occlusion. Vision is usually preserved in most bacterial forms of cavernous sinus thrombosis. CSF is frequently normal.
Death occurs rapidly unlike other fungal infection.
Actinomyces Israeli is responsible. It is a gram positive, anaerobic intermediate between classical bacteria and fungi, found in normal oral flora, may become pathogenic in states of moderate debilitation. The disease has 3 forms, cervicofacial, pulmonary and abdominal. Pulmonary forms are becoming more common. Spinal involvement is always secondary to an infection of contiguous tissue, rarely destroys the discs.