Rhino orbital cerebral mucormycosis: A life-threatening complication of coronavirus diseases 2019 in an uncontrolled diabetic patient
Hawra Ali Hussain Alsayed1
, Aymen Ali Al-Qurain2, Zeyad Faoor Alrais3
1Department of Pharmacy, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates
2Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
3Department of Anaesthesia and Intensive Care Unit, Anaesthesia and Intensive Care Unit, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates
Keywords: Coronavirus diseases 2019, case report, diabetes, fungal infection, mucorales, rhino‑orbital‑cerebral mucormycosis
Abstract
Mucormycosis is a progressive and life threatening disease that has been increasingly reported in patients infected by coronavirus diseases 2019 (COVID 19). We describe a case of rhino orbital mucormycosis with central nervous system involvement resulting in bilateral blindness and intracranial extension in a patient with uncontrolled diabetes mellitus (DM) and mild COVID 19 infection. A 35 year old obese male, recently diagnosed with DM, presented to the emergency department suffering from dizziness, headache, speech difficulty, and facial weakness. His glycosylated hemoglobin was 10.4% and his reverse transcriptase–polymerase chain reaction (PCR) test came positive for COVID 19. Ocular examination revealed left eye proptosis, ophthalmoplegia, and lid edema with no ocular movement. Imaging studies showed pansinusitis and periorbital and orbital cellulitis with intracranial involvement. Histopathology and biopsy examination confirmed mucormycosis. Medical management included glucose control and liposomal amphotericin B therapy. Septoplasty and functional endoscopic sinus surgery was performed as emergency procedures. The patient survived with bilateral blindness. In this case, we described the importance of considering mucormycosis in COVID 19 patients with uncontrolled diabetes, particularly those presenting with sinusitis, headache, and orbital edema symptoms. Despite intensive antifungal therapy and surgical intervention, it is a serious opportunistic fungal infection associated with long term complications.
How to cite this article: Alsayed HA, Al-Qurain AA, Alrais ZF. Rhino orbital cerebral mucormycosis: A life-threatening complication of coronavirus diseases 2019 in an uncontrolled diabetic patient. Turk J Emerg Med 2024;24(1):62-5.
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The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
HAHA (Lead): Conceptualization (lead), writing original draft (lead), reviewing, and editing the final draft (equal). AAAQ: reviewing and editing the final draft (equal). ZFA: supervised the case management (lead), reviewing and editing the final draft (equal).
None Declared.
None.