Mucormicosis rinocerebral e infeccin por SARS-CoV-2. Revisión de caso clínico e imagenológico en un paciente con diabetes mellitus mal controlada

Abstract

The clinical case of a 52-year-old man is presented, with a pathological history of type 2 diabetes mellitus and systemic arterial hypertension, the two with 3 years of evolution and metabolically decompensated for 8 months of evolution. He started with symptoms suggestive of SARS-CoV-2, which evolved in 2 weeks with increased dyspnea, fever, and left eye edema, for which he received in-hospital management. Control studies were performed, including computed tomography of the chest and skull, the first CO-RADS 5 report (very high suspicion of SARS-CoV-2 infection) with a severity scale due to severe extension; the second reported pneumocephalus in the left temporal fossa, left ocular infectious process, which conditioned proptosis, left intraorbital emphysema with involvement of the optic nerve and erosion of adjacent bone structures, as well as emphysema to the left masticatory space. During his stay, he presented an acute infectious process in the maxillary region, left eye and palate, for which mucormycosis pathology was suspected, and treatment with intravenous amphotericin was started. He required intensive therapy management and surgical intervention derived from the extension of the infection, which affected the brain tissue and generated complications and the death of the patient. Mucormycosis is a low prevalence and rapidly progressive disease caused by fungi of the Mucoraceae family of the Mucorales order. It is the fastest evolving fatal fungal disease in humans. For this reason, timely detection and treatment is of utmost importance for the survival of those affected by this agent. Keywords: Rhinocerebral mucormycosis; SARS-CoV-2 infection; COVID-19.