Rare case of hard palate mucomycosis complicated by peri-orbital swelling: A diagnostic challenge

Abstract

Mucormycosis is a rare but aggressive fungal infection predominantly affecting immunocompromised individuals. It presents significant diagnostic and therapeutic challenges, particularly when involving uncommon sites such as the hard palate and peri-orbital region. A 61-year-old male with a history of type II diabetes mellitus presented with peri-orbital swelling of the left eye, fever, and oral discomfort. His symptoms began following a dental extraction complicated by alveolar osteitis. Physical examination revealed a lesion on the hard palate, and laboratory tests indicated an underlying infection. MRI of the brain and orbits showed signal abnormalities consistent with an infectious process involving the preseptal and peri-orbital regions, with extension to the optic nerve and orbital muscles. Based on clinical, imaging, and medical history findings, a diagnosis of hard palate mucormycosis with peri-orbital involvement was established. The patient received intravenous meropenem, fluconazole, and insulin for diabetes management alongside symptomatic treatments. Gradual clinical improvement was noted, including a reduction in peri-orbital swelling and better oral intake. The patient was discharged with a continued plan for antifungal therapy and close diabetic monitoring. This case underscores the importance of early recognition and aggressive treatment of mucormycosis, especially in immunocompromised patients. A multidisciplinary approach, incorporating advanced imaging and comprehensive management of underlying conditions, is crucial in improving outcomes and reducing the high morbidity and mortality associated with this infection.