A Rare Case of Rhino Orbito Cerebral Mucor Mycosis Associated with COVID 19 Infection

Minu George, Neena Baby, Neethu Thambi, Sapna Joy, Suresh Kumar Radhakrishnan,Vinay Varghese Thomas and Pooja Prasad



Background: Severe Acute Respiratory Syndrome Coronavirus disease 2019 (COVID-19) infections is known to be associated with a wide range of bacterial and fungal secondary infections. This is report of a patient with uncontrolled blood sugar and COVID-19 infection, who developed rhino-orbito cerebral mucormycosis.

Design/results: A 50-year-old female, newly detected Type 2 diabetes mellitus, and RT-PCR positive for acute respiratory syndrome coronavirus 2 (SARS-CoV-2), developed left eye pain with decreased vision during the hospital course. She was on intravenous steroids and antibiotics for 8 days. Magnetic resonance imaging of brain, orbits with paranasal sinuses, showed pansinusitis, cavernous sinus thrombosis and orbital involvement with extensive cerebral infarcts involving the ACA and PCA territories. Broad aseptate filamentous fungal hyphae conforming to the morphology of mucormycosis were detected in the nasal swabs and culture-confirmed.

Conclusions: Extensive use of steroids, broad-spectrum antibiotics, antifungals and other immunosuppressive drugs, in the presence of uncontrolled diabetes, may lead to the development or exacerbation of an underlying fungal disease. Even in the absence of facial swelling and cellulitis, a high index of suspicion is necessary to detect secondary invasive fungal or bacterial infections in patients with COVID-19 disease.

Published on: July 02, 2021
doi: 10.17756/jnen.2021-085
Citation: George M, Baby N, Thambi N, Joy S, Radhakrishnan SK, Thomas VV, Prasad P. 2021. A Rare Case of Rhino Orbito Cerebral Mucor Mycosis Associated with COVID 19 Infection. J Neurol Exp Neurosci 7(1): 33-37.