Introduction

In the early 2021 started with mutation of SARS CoV2 and emergence of B.1.617.1 or Delta variant leading to a deadly resurgence of the disease. This highly virulent strain led to increased mortality due to its high infectivity and virulence1. Outbreak of new opportunistic infection mucormycosis was seen among the post covid patients. These secondary fungal infections or coinfections are critical challenges increasing the patient’s morbidity and mortality. India has reported the highest number of mucormycosis cases in the world, especially following the second wave of the pandemic2. Mucormycosis was declared as an epidemic by the Government of India3 due to surge in the cases. The mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B through the multidisciplinary teams in hospitals across India4. Now, following the initial treatment of mucormycosis there is a resurgence, in the form of fungal osteomyelitis of the frontal bone. This form of presentation has not been previous recognized, with only a very few case reports describing it. The resurgence of this disease is attributed to the incomplete clearance, inadequate amphotericin dosing, comorbidities, immune status and previous disease extent4,5.
Here in this article, we describe the presentation, clinical features, radiological, intraoperative findings, and post operative outcomes following the management of frontal osteomyelitis of fungal origin.