Abstract

MUCORMYCOSIS: ASSESSMENT OF RISK FACTORS IN A SUBJECT SUFFERING FROM CONGENITAL HAEMOPHILIA

Baratha Jyothi N.*, Aruna M. and B. Karuna Harika

ABSTRACT

The present paper communicates a rare presentation of COVID-19 infection in a 32-year-old male patient, who presented with black fungus infection after recovery from corona infection during second lock down period and development of the classic symptoms for COVID-19. Subject is suffering from congenital Haemophilia of Factor IX and diabetes. COVID-19 infection has been associated with fungal infections. Mucormycosis is more often seen in immunocompromised individuals, and complications of orbital and cerebral involvement are likely in diabetic ketoacidosis and with concomitant use of steroids. Rhinocerebral mucormycosis is a rare opportunistic infection of the sinuses, nasal passages, oral cavity, and brain caused by saprophytic fungi. The infection can rapidly result in death. Rhinocerebral mucormycosis commonly affects individuals with diabetes and those in immunocompromised states. CT brain scan showing the appearance of a cerebral infarct. CT scan of a patient who is suspected of having mucormycosis shows extensive involvement of the right orbit and adjacent sinuses. There was total ophthalmoplegia of the right eye. He incidentally tested positive for COVID-19. An emergency functional endoscopic sinus procedure was done, which confirmed mucormycosis on histopathological examination. After 1 week of conventional amphotericin B and antibiotics, repeat CT brain showed improvement in mucosal thickening and sinusitis. This case is a rare presentation of mucormycosis associated with rapid progression to orbital apex syndrome with brain infarction in a patient with non-ketotic diabetes and COVID-19. Early diagnosis and treatment are essential to prevent further end-organ damage.

Keywords: Haemophilia of Factor IX, Mucormycosis, mucosal Thickening and Sinusitis, amphotericin B.