Rhino-Orbital-Cerebral Mucormycosis With Intracranial Extension in a Patient With Diabetic Ketoacidosis

Rhino-orbital-cerebral mucormycosis (ROCM) is a rare but highly aggressive fungal infection that predominantly affects immunocompromised individuals, with diabetic ketoacidosis (DKA) being one of the most important predisposing factors. We report the case of a 44-year-old woman from León, Nicaragua, with poorly controlled type 2 diabetes mellitus who presented with fever, upper respiratory symptoms, palatal ulceration, and progressive orbital involvement. She was admitted in severe DKA and diagnosed with invasive ROCM based on histopathological findings of broad, ribbon-like, aseptate hyphae with right-angle branching. Despite early initiation of amphotericin B and subsequent surgical debridement, the infection proved fatal. This case highlights the need for timely recognition, combined antifungal and surgical management, and optimization of underlying metabolic conditions to improve outcomes in ROCM.