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COVID-19-Related Rhino-Orbital-Cerebral Mucormycosis With Angioinvasion: A Lethal Sequelae
Nur Syazwani Redzuwan1,2, Andrea Lillianne Barr Kumarakulasinghe2, Wan Mariny W Md Kasim3
1Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Abstract:
A middle-aged man with multiple comorbidities including uncontrolled diabetes mellitus presented with shortness of breath and lethargy for six days. He was treated for COVID-19 pneumonia, requiring high cumulative steroid therapy. After 15 days of treatment, he developed right orbital apex syndrome with central retinal artery occlusion secondary to invasive mucormycosis. The infection progressed rapidly despite aggressive medical treatment, systemic anti-fungal therapy along with local transcutaneous retrobulbar amphotericin B injection. We report our battle in fighting this vicious disease. Judicious use of immunomodulators in COVID-19 treatment and close monitoring is crucial, especially in high-risk patients.
Insights
This case study highlights a severe invasive mucormycosis complication, including orbital apex syndrome and central retinal artery occlusion, in a diabetic COVID-19 patient on steroids. Close monitoring of high-risk patients is crucial to prevent such aggressive fungal infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19 treatment, particularly high-dose steroid therapy, can increase the risk of opportunistic infections.
- Invasive mucormycosis is a rare but aggressive fungal infection, often affecting immunocompromised individuals.
- Uncontrolled diabetes mellitus is a significant risk factor for mucormycosis.
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