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Rhino-Orbital-Cerebral Mucormycosis in a Post-COVID-19 Patient from Peru

Linda Ponce-Rosas1, Jose Gonzales-Zamora2, Nelson Diaz-Reyes3,4

  • 1Peruvian American Medical Society, Especialistas en Gestion de Salud Ocupacional, Lima, Peru.

Case Reports in Infectious Diseases
|March 18, 2022
PubMed

Insights

This case report highlights a rare fungal infection, mucormycosis, in a COVID-19 patient with diabetes. Isavuconazole proved effective and well-tolerated, offering a viable alternative treatment option.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Mucormycosis is increasingly reported in COVID-19 patients, particularly in India.
  • Limited data exists on this association in Latin America.
  • This report details a severe case in Peru.

Observation:

  • A 66-year-old female presented with rhino-orbital-cerebral mucormycosis, diabetic ketoacidosis, and COVID-19.
  • The infection involved sinuses, orbits, and intracranial extension.
  • Initial treatment with isavuconazole was initiated due to amphotericin B unavailability, alongside surgical debridement.

Findings:

  • Isavuconazole demonstrated efficacy and good tolerance over 10 months, with no reported side effects.
  • The patient underwent surgical debridement and multiple manual debridement sessions for disease clearance.
  • This case emphasizes the importance of suspecting mucormycosis in post-COVID-19 patients with diabetes.

Implications:

  • Isavuconazole can be a viable alternative therapy for mucormycosis in resource-limited settings.
  • Prompt diagnosis and management are crucial for favorable outcomes in these complex cases.
  • Increased awareness of mucormycosis in immunocompromised COVID-19 survivors is warranted.

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