Isolated orbital mucormycosis in the setting of COVID-19 pneumonia

Mucormycosis is a fungal infection most commonly affecting severely ill patients, with increasing incidence in the setting of the COVID-19 pandemic. Due to its ability to involve multiple structures including the paranasal sinuses, orbit, and brain, mucormycosis infections present with variable clinical signs. All previously reported cases of mucormycosis in the literature involved paranasal sinus involvement, most commonly the ethmoid sinus. Herein we present the first reported case of isolated orbital mucormycosis without histologic evidence of paranasal sinus infection. Prompt recognition of atypical mucormycosis infections in the absence of paranasal sinus involvement in critically ill patients is necessary in order to initiate early and aggressive treatment due to the high fatality rate and rarity of this presentation.