Multifaceted Challenges in Recurrent Rhino-Orbital Mucormycosis: Concomitant Oronasal Myiasis and Lichtheimia Co-Infection in a Post-COVID-19 Patient

Post-COVID-19 rhino-orbital mucormycosis poses significant challenges, particularly when complicated by coinfections.We present the case of a 60-years-old male with Type II diabetes, who developed recurrent rhino-orbital mucormycosis with concomitant oronasal myiasis and Lichtheimia co-infection.The patient presented with facial swelling, vision loss, and oral maggots.Imaging revealed necrotic bone exposure and residual mucormycosis in the paranasal sinuses.Fungal culture confirmed Lichtheimia species.Multidisciplinary management included manual maggot removal, necrotic tissue debridement, retrobulbar Liposomal Amphotericin B injections, and glycemic control.A total of 72 maggots were extracted from the maxillary antrum.