Diabetic Ketoacidosis Complicated With Extensive Rhinocerebral Mucormycosis and Bilateral Amaurosis in a Pediatric Patient

Mucormycosis is a rare invasive fungal infection characterized by rapid progression and high mortality, caused by fungi of the order <i>Mucorales</i>. Patients with diabetes and inadequate glycemic control, particularly those in ketoacidosis, constitute an important risk group. We report the case of a 10-year-old boy admitted with diabetic ketoacidosis, who developed behavioral changes and bilateral visual loss. Imaging studies confirmed invasive fungal rhinosinusitis with intracranial extension and orbital and cerebral involvement. Treatment included surgical debridement and prolonged antifungal therapy (liposomal amphotericin B and isavuconazole). The patient was discharged from the hospital after 142 days of hospitalization, with irreversible visual loss. This case highlights the need for immediate recognition of orbital or neurological signs associated with rhinocerebral mucormycosis. Early clinical recognition, appropriate antifungal therapy, aggressive surgical debridement, and intensive glycemic control are fundamental pillars of treatment and influence the prognosis.