Invasive mucormycosis in a patient with diabetes mellitus: a case report
Mucormicosis invasiva en una paciente con diabetes mellitus
DOI:
https://doi.org/10.52428/20756208.v20i49.1406Keywords:
Diabetes mellitus, Mucormycosis, Oportunistic infection, Paranasal sinusesAbstract
Rhinocerebral mucormycosis is an invasive fungal infection with high mortality in patients with uncontrolled diabetes. The objective was to describe the clinical, diagnostic, and therapeutic characteristics of a case of rhinocerebral mucormycosis with cerebral vascular complications. We present the case of a 51-year-old man with uncontrolled type 2 diabetes mellitus who developed rhinocerebral mucormycosis complicated by occlusion of the right internal carotid artery and ischemic cerebral infarcts. The diagnosis was established by magnetic resonance imaging, which showed cerebral infarcts and fungal angioinvasion. This was confirmed by histopathological examination of a paranasal sinus biopsy, which revealed coenocytic hyphae characteristic of the order mucorales. Management included amphotericin B (cumulative dose: 2150 mg), surgical debridement of the sphenoid and ethmoid sinuses, and optimization of metabolic control (final HbA1c: 8.4%). The patient presented with Acinetobacter baumannii coinfection, requiring antibiotic adjustment. The fungal infection improved, but neurological (right cranial nerve II-VI paralysis) and ophthalmological sequelae persisted. This case underscores the importance of early diagnosis, aggressive antifungal treatment, and strict glycemic control in mucormycosis associated with diabetes. A multidisciplinary approach is essential for managing the vascular and neurological complications of this opportunistic infection.
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Copyright (c) 2025 Renata María León Stimson, Gloria Raquel Llanes, Jesús Felipe González Jiménez , Juan Víctor Fabián Mendoza Morel
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