Caspian Journal of Neurological Sciences (Jan 2023)
A Case of Recovered Severe Rhino-Orbito-Cerebral Mucormycosis
Abstract
Background: Mucormycosis is a rare disease with high morbidity and mortality, and its diagnosis is difficult and often delayed. Also, the disease tends to progress rapidly. Therefore, urgent surgical and medical intervention is lifesaving. Case Presentation: A 24-year-old woman with diabetes since 3 months ago presented with excessive tearing in her left eye, unilateral headache with epistaxis, and loss of consciousness at Razi Hospital, Rasht City, Iran, in June 2021. A clinical and pathologic diagnosis of mucormycosis was established. Imaging the head and paranasal sinuses revealed extensive involvement of the brain, paranasal sinuses, and left orbit. Treatment with liposomal amphotericin B (5 mg/kg) was administered for about 50 days until discharge. During the treatment period, the patient underwent several surgical procedures, such as enucleation of the left eye, surgery on soft and hard palates, sinuses, and neurosurgery for debridement of necrotizing tissues. After 50 days of intensive medical and surgical treatments, the patient was recovered and discharged. Conclusion: In the era of the COVID-19 pandemic, many diabetic patients acquire that infection. Physicians caring for these patients should be alert to mucormycosis as a complication of severe or mild COVID-19 infection. Early diagnostic and therapeutic interventions could be lifesaving for these patients.
