A Case of Mucormycosis with Covid-19 with a Conservative Medical Management, a Rare Management Approach

Abstract

Mucormycosis is an infection caused by fungi belonging to the order Mucorales. It has been reported in many patients following COVID-19 infection, particularly in those with Diabetes Mellitus and in those treated with steroids. The most common type in patients with diabetes, rhino-orbito-cerebral mucormycosis, is associated with various neurological complications. In this report, we describe the case of a 71-year-old female with diabetes and hypertension, who presented one week after recovering from Covid-19 infection, with symptoms of severe headache and, right eye ptosis, ophthalmoplegia and decreasing visual aquity. Brain CT scan showed features of maxillary sinusitis. Nasal biopsy and cultures revealed mucormycosis. She was managed with Amphotericin-B with improvement in headache and persistence of eye complications. Three months after discharge, she presented to the emergency department complaining of left-sided weakness. Brain MRI showed an acute ischemic infarction with totally occluded right internal carotid artery, progressive boney destruction of the right maxillary sinuses, and inflammation of the right orbit and cavernous sinus. As she refused surgical debridement, she was admitted and managed conservatively with Amphotericin-B.