Mucormycosis in a Patient with Uncontrolled Diabetes Mellitus

Abstract

Mucormycosis;is a rapidly progressive fungal infection due to filamentous fungi of the mucoraceae family. In this case report, we aimed to present the diagnosis and treatment modalities of a patient who developed rhinoorbital mucormycosis. A 54-year-old patient with a history of hypertension applied to the emergency department with a complaint of wound in the mouth that started four days ago. In the examinations performed here, the patient was diagnosed with diabetic ketoacidosis. In the examination of the patient, it was found that there was a necrotic wound on the left hard palate, a necrotic wound extending from the left inferior turbinate to the nasopharynx, and hyphae in the nasal passage. The patient underwent an aggressive debridement operation on the third day, due to the growth in the fungal culture. In the following clinical examination of the patient, ketone in the urine became negative, and his acidosis status improved. On the same day, the patient was treated with a positive coronavirus disease-2019 (COVID-19) polymerase chain reaction. After 15 days of treatment, the patient died due to COVID-19 pneumonia. Mucormycosis should be doubtful in patients presenting with uncontrolled diabetes mellitus and severe sinoorbital infection. All physicians following diabetic ketoacidosis should be vigilant against this rapidly progressing disease with high mortality. (English) [ FROM AUTHOR] Mukormikoz mucoraceae familyasının filamentli mantarlarına bağlı hızla ilerleyen bir mantar enfeksiyonudur. Bu olgu sunumunda rinoorbital mukormikoz gelişen bir hastanın tanı ve tedavi yöntemlerini sunmayı amaçladık. Elli dört yaşında hipertansiyon öyküsü olan hasta, dört gün önce başlayan ağızda yara şikayeti ile acil servise başvurdu. Burada yapılan tetkiklerde hastaya diyabetik ketoasidoz tanısı konuldu. Hastanın muayenesinde sol sert damakta nekrotik yara, sol alt konkadan nazofarenkse kadar uzanan nekrotik yara ve burun pasajında hifa tespit edildi. Üçüncü gün mantar kültüründe üreme olması üzerine hastaya agresif debridman operasyonu uygulandı. Hastanın sonraki klinik muayenesinde idrarda keton negatif çıktı ve asidoz durumu düzeldi. Aynı gün hasta pozitif koronavirüs hastalığı-2019 (COVID-19) polimeraz zincir reaksiyonu ile tedavi edildi. On beş günlük tedaviden sonra hasta COVID-19 pnömonisi nedeniyle eksitus kabul edildi. Kontrolsüz diabetes mellitus ve şiddetli sino-orbital enfeksiyon ile başvuran hastalarda mukormikozdan şüphelenilmelidir. Diyabetik ketoasidoz sonrası tüm hekimler hızla ilerleyen ve mortalitesi yüksek olan bu hastalığa karşı dikkatli olmalıdırlar. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)