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Rhino-orbito-cerebral mucormycosis in new-onset type 1 diabetes mellitus: a case-based short review

Isabella Sharifi1, Alejandra Razzeto1, Susana Barreiro Sacco1

  • 1Division of Endocrinology, Department of Internal Medicine, University of Miami Miller School of Medicine, 1450 Northwest 10th Avenue, Miami, FL 33136, USA.

The American Journal of the Medical Sciences
|March 7, 2026
PubMed

Insights

Mucormycosis, a severe fungal infection, particularly affects patients with diabetic ketoacidosis (DKA). Early diagnosis and treatment, including surgery and antifungal drugs, are crucial for survival in diabetic patients.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Endocrinology

Background:

  • Mucormycosis is an aggressive angioinvasive fungal infection.
  • Patients with diabetic ketoacidosis (DKA) are uniquely susceptible.
  • Hyperglycemia and acidosis in DKA enhance fungal invasion and impair immune defenses.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, diagnosis, and management of rhino-orbito-cerebral mucormycosis.
  • To highlight the importance of prompt recognition and multidisciplinary care in diabetic patients.
  • To discuss emerging diagnostic and therapeutic developments.

Main Methods:

  • Case vignette presentation.
  • Review of current literature on mucormycosis in diabetic patients.
  • Discussion of diagnostic tools and treatment strategies.

Main Results:

  • Rapid recognition, urgent surgical debridement, and prompt high-dose liposomal amphotericin B are essential.
  • Reversal of metabolic derangements is a cornerstone of care.
  • Newer antifungals like isavuconazole and posaconazole show promise for step-down therapy.

Conclusions:

  • Outcomes in mucormycosis are time-dependent.
  • Clinicians should suspect invasive fungal sinusitis in diabetic patients with DM.
  • Multidisciplinary evaluation and timely intervention are critical for improved patient outcomes.
Keywords:
Amphotericin BDiabetic ketoacidosisInvasive fungal sinusitisMucormycosisRhino-orbito-cerebral

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