Teaching NeuroImages: Mucormycosis-associated vasculitis

A diabetic 54-year-old woman with HIV infection presented headache, nasal discharge, and ophthalmoplegia for 1 month. CSF showed lymphocytic pleocytosis. CT disclosed invasive sinusopathy. Histopathologic analysis confirmed mucormycosis (figure 1). Angiography with high-resolution vessel wall imaging (HR-VWI) was performed (figure 2). She died despite surgical debridements and treatment with liposomal amphotericin B.