Acute Fulminant Rhinocerebral Mucormycosis: A Case Report with Review of Management

Abstract

Rhinocerebral mucormycosis is an uncommon, rapidly advancing, catastrophic, opportunistic fungal infection that predominantly affects metabolic and/or immunologically challenged individuals. Its frequency has increased dramatically since the SARS-COV-19 epidemic. The disease has been described as having distinct clinical categories, namely: rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated. Extranasal dissemination has been invariably linked with an increased risk of death. Though an aggressive disease with a substantial rate of mortality, seeking timely help, prompt investigations and diagnosis, treatment with higher antibiotics, oral or intravenous antifungals, rigorous surgical excision, and control of underlying comorbidities has resulted in effective disease management and control with a gratifying outcome and lower morbidity when compared to the pre COVID era. We present a case of sinonasal mucormycosis with ocular, oral, pulmonary, and intracranial involvement in a young post COVID-19 immunocompromised male patient who was optimally treated with a comprehensive endoscopic surgical approach and combined with oral and systemic liposomal amphotericin B therapy.