Frontal osteomyelitis post-COVID-19 associated mucormycosis

Area of Science:

• Infectious Diseases
• Ophthalmology
• Neurosurgery
• Otolaryngology
• Plastic Surgery

Background:

• Rhino-orbito-cerebral mucormycosis (ROCM) is a severe fungal infection, frequently occurring as a secondary infection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• Osteomyelitis, particularly of the frontal bone, is an exceptionally rare sequela of ROCM.

Observation:

• This case series details four patients who developed frontal bone osteomyelitis subsequent to ROCM treatment after contracting coronavirus disease 2019 (COVID-19).
• These patients underwent both surgical and medical management for ROCM prior to the onset of frontal osteomyelitis.

Findings:

• This study represents the first case series to document frontal bone osteomyelitis as a complication in patients with post-COVID-19 mucormycosis.
• All four patients survived, with one experiencing preserved vision and salvage of the affected eye, highlighting the potential for positive outcomes with timely intervention.

Implications:

• Frontal osteomyelitis in post-COVID-19 mucormycosis is a life-threatening complication that can lead to significant facial disfigurement.
• Early diagnosis and intervention are critical to prevent severe facial deformities and potentially fatal intracranial extension of the infection.