An Unusual Presentation of Cryptogenic Pulmonary Mucormycosis Related to COVID-19 Infection – A Case Report

Abstract

Introduction: We present a unique and rare case of post-COVID cryptogenic primary pulmonary mucormycosis manifesting with nonspecific 3-week history of low-grade fever and fatigue but without any localizing symptoms related to the chest. Material and Method: The first symptom which suggested a sinister underlying illness was limb-shaking TIAs (Transient Ischemic Attacks) related to hematogenous intracranial vascular spread of the infection. This was followed by a corpus callosal hemorrhage due to rupture of a mycotic aneurysm. Discussion: Mycotic intracranial aneurysm (MIA) from Mucor species is most often the result of extravascular spread from skull base infections though they may rarely occur due to hematogenous seeding. The case highlights the need for high index of suspicion in the appropriate clinical setting for a possible post-COVID cryptogenic pulmonary Mucor infection. We present a unique and rare case of an MIA in a patient with a cryptogenic primary pulmonary mucormycosis, without any evidence of associated sinus or skull base Mucor involvement.