Survival from Rhino-Orbital-Cerebral Mucormycosis in SARS-CoV-2-Positive Diabetic Patients: Two Case Reports.

Lädrach, Claudia; Wartenberg, Martin; Zimmerli, Stefan; Anschuetz, Lukas; Bohlen, Stefan; Ebner, Julian; de Gouyon Matignon de Pontouraude, Claire M F; Caversaccio, Marco; Wagner, Franca (2024). Survival from Rhino-Orbital-Cerebral Mucormycosis in SARS-CoV-2-Positive Diabetic Patients: Two Case Reports. Case reports in neurology, 16(1), pp. 89-98. Karger 10.1159/000538539

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INTRODUCTION

Rhino-orbital-cerebral mucormycosis (ROCM) is a rare angioinvasive fungal infection known to be associated with high morbidity and over 50% mortality. ROCM is becoming more common due to an increase in predisposing immunocompromising comorbidities as well as COVID-19.

CASE PRESENTATIONS

We report 2 cases - a 75-year-old woman with diabetes and a 39-year-old man with recurrent diabetic ketoacidosis. Both presented initially with acute sinonasal symptoms, were positive for SARS-CoV-2, and diagnosed with acute ROCM. Both underwent mutilating surgical therapy as well as high-dose amphotericin B treatment. With continued oral antifungal treatment, patient 1 showed stable symptoms despite radiographically increasing disease and died of urosepsis 5 months after first surgery. With posaconazole treatment, patient 2 recovered from the disease and showed no clinical sign of disease progression after 1 year.

CONCLUSION

Despite the rarity of the disease, ROCM should be considered if the findings of clinical and radiological examination fit, so that a delay in treatment initiation can be avoided. As our both cases show, survival from ROCM is possible - albeit at a high cost.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Craniomaxillofacial Surgery

UniBE Contributor:

Lädrach, Claudia Stephanie, Wartenberg, Martin, Anschütz, Lukas Peter, Bohlen, Stefan, Ebner, Julian Jakob, Caversaccio, Marco, Wagner, Franca

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1662-680X

Publisher:

Karger

Language:

English

Submitter:

Pubmed Import

Date Deposited:

01 May 2024 15:22

Last Modified:

02 May 2024 05:56

Publisher DOI:

10.1159/000538539

PubMed ID:

38690082

Uncontrolled Keywords:

Amphotericin B COVID-19 Invasive fungal infection Orbital apex syndrome Rhino-orbital-cerebral mucormycosis

BORIS DOI:

10.48350/196432

URI:

https://boris.unibe.ch/id/eprint/196432

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