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A tip from the nose: rhinocerebral mucormycosis in a patient with alcoholic liver cirrhosis and cocaine abuse, an uncommon association
  1. David Avelar Rodriguez,
  2. Gabriel Ochoa Virgen,
  3. Roberto Carlos Miranda Ackerman
  1. Intensive Care Unit, Hospital San Javier, Guadalajara, Jalisco, Mexico
  1. Correspondence to Dr David Avelar Rodriguez, davidavelar1{at}


We present the case of a 28-year-old man with a long-standing history of cocaine abuse and Child-Pugh class C alcoholic liver cirrhosis who developed severe lower respiratory tract infection complicated with septic shock and multiple organ dysfunction. He was managed in the intensive care unit. On the eighth day after admission, he developed a nose discolouration, which was initially thought to be associated with high-dose vasopressors. Despite the reduction of vasopressors, the lesion progressed rapidly. It was later diagnosed as rhinocerebral mucormycosis. Amphotericin B was administered, but unfortunately the patient succumbed to the complications postinfection. The association between alcoholic liver cirrhosis and rhinocerebral mucormycosis should be known and prompt recognition warrants immediate treatment.

  • alcoholic liver disease
  • cirrhosis
  • adult intensive care
  • infectious diseases
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  • Contributors DAR and GOV collected the information and images, carried out the literature review, wrote the manuscript and revised it extensively. RCMA was involved in the patient's care, wrote and edited the manuscript and revised it extensively. All the authors approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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