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A Rare Case of Rhizopus Oryzae Keratitis following Orbital Cellulitis in a Diabetic Patient

Rhizopus Oryzae is an ubiquitous aseptate fungi belonging to order Mucorales. Rhizopus keratitis is rare and has been reported from external sources leading to corneal inoculation including trauma, surgery, contact lens use and cocaine abuse. Rhizopus Oryzae acute fulminant keratitis as a sequelae to orbital cellulitis was reported by Khalili et al. in a patient with Thalassemia major requiring therapeutic keratoplasty. To the best of our knowledge, this is the first case of a diabetic patient presenting with Rhizopus keratitis following orbital cellulitis with evidence of KOH smear and Polymerase Chain Reaction (PCR) positivity both from cornea and nasal swab 4 months after initial presentation that responded successfully to medical management. Furthermore, the presence of aseptate fungal filaments was demonstrated from maxillectomy specimen 9 months from the initial presentation indicating that Rhizopus can be indolent if inadequately treated.