Rhino-Orbital Mucormycosis After COVID-19 Infection in a Patient With Non-Hodgkin’s Lymphoma

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be succeeded by a spectrum of complications, including invasive fungal infections (IFIs). Here, we describe a case of rhino-orbital mucormycosis in a recovered coronavirus disease-19 (COVID-19) patient with underlying non-Hodgkin's lymphoma (NHL). Our patient was normotensive, non-diabetic, presenting with multiple non-healing ulcers on different parts of the body. She received high-dose glucocorticoids and antibiotics during her severe COVID-19 illness. Three weeks following COVID-19 detection, she developed progressive rhino-orbital lesion with profuse pus formation, along with pain and redness of the left eye. Histopathology from the lesion revealed mucormycosis. She was treated with Amphotericin B. Unfortunately, the patient died after the first cycle of chemotherapy for NHL. Due to the high chance of mortality, timely clinical suspicion along with microbiological diagnosis is necessary for the early detection of infection. Strong policymaking should also be implicated to revisit the cost effectiveness of available treatments to reduce case fatality.

Rhino-Orbital Cerebral Mucormycosis in a Non-diabetic Patient Following COVID-19 Infection: A Case Report and Literature Review

“…Baskar et al reported a case of rhino-orbital cerebral mucormycosis caused by COVID-19 infection in a non-diabetic patient [ 12 ]. Hannan et al also reported a case of COVID-19-induced mucormycosis in a non-diabetic patient diagnosed with non-Hodgkin lymphoma [ 13 ]. Mucormycosis is usually reported in patients with compromised immunity with associated comorbidities.…”

“…Important interventions for controlling mucormycosis are early diagnosis, reversing the predisposing factors, surgical debridement of the infected tissue, and relevant therapeutic antifungal therapy [ 13 ]. COVID-19 patients have been prescribed steroids, which may suppress immunity in recovering and recovered COVID-19 patients and thereby can trigger mucormycosis infection [ 14 ].…”