Survival of rhino-orbital-cerebral mucormycosis in SARS-COV-2 positive
diabetic patients: Two case reports
Abstract
Abstract Rhino-orbital-cerebral mucormycosis (ROCM) is a rare
angioinvasive fungal infection known to be associated with high
morbidity and over 50% mortality and has increased lately due to
increasing predisposing immunocompromising comorbidities as well as
COVID-19. In addition to the common acute disease progression, chronic
less aggressive courses have been described less often. In this paper we
report two cases – a 75-year-old woman with diabetes and a 39-year-old
man with recurrent diabetic ketoacidosis. Both presented initially with
acute sinonasal symptoms, were positive for SARS-COV-2 and later
diagnosed with acute ROCM. Both underwent mutilating surgical therapy as
well as high administered dose Amphotericin B and long term continuous
antifungal therapy. Patient 1 showed stable symptoms with
radiographically increasing disease and died of urosepsis 5 months after
first surgery. Patient 2 was first lost to follow-up after repatriation
to his home country and 1 year later sent us a holiday picture of
himself, having recovered from the disease. Key words:
Rhino-orbital-cerebral mucormycosis, mucormycosis, Amphotericin-B,
COVID-19, invasive fungal infection