Clinical Course of Four Patients with Mucormycosis Managed Predominantly with Ayurveda-Based Interventions: A Case Series

Mucormycosis is a rapidly progressive angioinvasive fungal infection caused by Mucorales, predominantly affecting immunocompromised individuals and associated with substantial morbidity and mortality. Despite advances in standard care involving surgical debridement and systemic antifungal therapy, outcomes may remain suboptimal because of recurrence, treatment-related toxicity, including nephrotoxicity associated with amphotericin B, and substantial economic burden. These challenges justify continued investigation of adjunctive therapies and other approaches that may potentially improve outcomes or reduce treatment burden, while established antifungal therapy and surgical management remain the cornerstone of care. Ayurveda, a traditional system of medicine in India, employs comprehensive therapeutic strategies that may include oral formulations, local interventions, dietary regulation, and lifestyle modifications. Ayurveda has been utilised by patients with mucormycosis; however, its evidence base remains limited and largely restricted to adjunctive or isolated case reports. This paper presents a descriptive case series of four patients diagnosed with mucormycosis who were managed predominantly with Ayurveda-based interventions. Three patients opted to receive stand-alone Ayurveda-based treatment after declining recommended standard biomedical treatment. All patients had complex comorbidities, including diabetes mellitus, hypertension, and renal impairment. Serial follow-up imaging documented radiological changes interpreted by the reporting radiologists as improvement in three patients, with no documented recurrence during the available follow-up periods. One patient with suboptimal treatment adherence showed persistent radiological abnormalities at the three-month assessment, although survival was maintained for approximately one year following diagnosis. No treatment-related adverse events were documented in the available follow-up records; one patient with pre-existing renal impairment showed an increase in serum creatinine from 1.48 to 3.3 mg/dL during follow-up. These observations are descriptive and derive from an uncontrolled case series with non-standardised follow-up and outcome assessment. They do not establish treatment effectiveness, safety, non-inferiority, or suitability for clinical application and should not be interpreted as evidence supporting replacement of current standard-of-care management. Rather, these observations advance ongoing hypothesis generation and provide conceptual and methodological insights for the development of future clinical research protocols evaluating predominantly Ayurveda-based interventions for mucormycosis care.