Case Report of Sino-Orbital-Cerebral Mucormycosis in a Renal Transplant Patient

Mucormycosis is a rare but severe opportunistic fungal infection caused by Mucorales fungi, primarily affecting immunocompromised individuals. It is commonly seen in patients with uncontrolled diabetes, organ transplants, and conditions requiring immunosuppression. The infection can manifest in various forms, including rhino-cerebral, pulmonary, cutaneous, and disseminated types, with the classic presentation being rhino-sino-orbital involvement. Early diagnosis and treatment are critical for improving survival outcomes. This case concerns a 58-year-old female with a history of type II diabetes, diabetic nephropathy, and recent kidney transplantation. Two months post-transplant, she developed severe left-sided headaches, facial edema, and systemic symptoms. Initial diagnosis pointed to ethmoiditis and maxillary sinusitis, but due to worsening symptoms, further investigations revealed mucormycosis with Rhizopus Arrhizus confirmed through PCR. The infection rapidly progressed, leading to orbital and neurological involvement, and despite antifungal therapy with Ambisome and Isavuconazole, the patient’s condition deteriorated, resulting in death one month after treatment initiation. Mucormycosis is particularly dangerous in immunocompromised patients due to rapid progression and high mortality rates. Early detection through histopathology or molecular methods like PCR is crucial. Treatment involves antifungal therapy, surgical debridement, and careful management of immunosuppression. Although amphotericin B is the most effective antifungal, adjusting immunosuppressive therapy remains a challenge, balancing rejection risk and infection control. This case underscores the importance of vigilance in diagnosing and managing mucormycosis, especially in transplant patients, where timely intervention can significantly impact outcomes.