Rhino-orbital-cerebral angioinvasive mucormycosis in two diabetic patients with COVID-19

Abstract

Mucormycosis is a rare infection whose main risk factor is diabetes mellitus, and whose frequency has increased during the COVID-19 pandemic. Two cases of rhino-orbital-cerebral angioinvasive mucormycosis are described in adult male diabetic patients with COVID-19. Both cases had necrotic facial and orbital lesions, affecting the paranasal sinuses and involving the cavernous sinus and the internal carotid artery, which caused cerebral infarcts. They were diagnosed by finding mycotic structures in tissue from one of the patients and by directly examining secretions in the other. Both patients were treated with amphotericin B deoxycholate and one of them was taken to surgery; however, both cases had a fatal outcome. We emphasize the need for early diagnosis and immediate use of antifungal medications with proven efficacy.