Fatal Rhinoorbital Mucormycosis in a Child with Fanconi Anemia: The Critical Role of CT Imaging

Mucormycosis is a severe, angioinvasive fungal infection associated with elevated mortality rates, particularly in immunocompromised patients. Rhinoorbital mucormycosis (ROM) is one of its most prevalent and fatal forms, typically manifesting with nonspecific sinonasal symptoms before rapidly advancing to orbital and intracranial complications. Prompt identification of subtle imaging signs is essential for early intervention. We present a case of rhinoorbital mucormycosis in a 10-year-old child with Fanconi anemia-associated bone marrow aplasia, emphasizing critical CT findings including obliteration of peri-antral fat, deep facial and masticator space involvement, extension through the sphenopalatine fissure and inferior orbital fissure, and progressive orbital proptosis. This case highlights the pivotal role of CT imaging in early extrasinus disease detection and the unique challenges of management in a severely thrombocytopenic pediatric patient in whom surgical debridement a cornerstone of treatment was formally contraindicated.