Case #15:

Clinical Presentation:
A 53-year-old renal transplant recipient presented with headaches, diploplia,blurred vision and purulent nasal discharge. Proptosis, focal neurologic deficits and obtundation ensued. The patient died 48 hours later. His medications included prednisone and azathioprine.

Clinical Diagnoses:
Invasive Rhinocerebral Mucormycosis

Case 15 Images 1 and 2: cerebral meningeal blood vessel invaded with broad hyphal elements.

Discussion:
Microbiologic Diagnosis:
Cerebral Vasculitis Due to Invasive Mucormycosis

Despite a pre-mortem diagnosis treated with medical and surgical therapies the patient had an unremitting course with evidence of direct vascular invasion on microscopy.