POST-COVID ROCM (RHINO ORBITAL CEREBRAL MUCORMYCOSIS) INVOLVING SKULL BASE – A RARE CASE REPORT

Abstract

INTRODUCTION Mucormycosis in the setting of COVID-19 has given rise to the concept of 'epidemic within a pandemic'. It is a life-threatening fungal infection caused by fungi belonging to class Zygomycetes. It has got special affinity for the immunocompromised which is one of the main reasons for the flare up of the disease during COVID. Rhino-orbito-cerebral Mucormycosis (ROCM) is by far known to be the most common form of this disease. This usually presents with nasal dryness and blockage, swelling and numbness of cheek, blackish discoloration of nose, cheek and palate. It has been seen that in late stages of mu c o rmy c o s i s , p a t i e n t s p r e s e n t e d w i t h ophthalmoplegia, diminuition of vision, loss of vision, altered sensorium or even facial palsy. MATERIAL AND METHOD We here-in report a rare case of a 67-year-old diabetic male who was diagnosed with post- COVID Mucormycosis involving skull base with right abducens nerve and right hypoglossal nerve palsies. Management comprised of endoscopic debridement of the disease followed by administration of liposomal amphotericin. Patient was followed for 6 months with repeated nasal endoscopies and follow-up MRI. CONCLUSION There was visible recovery of the sixth and twelfth nerves. No recurrence has been observed. K e y w o r d s – R h i n o - o r b i t o - c e r e b r a l m u c o r m y c o s i s , a b d u c e n s n e r v e p a l s y, h y p o g l o s s a l n e r v e p a l s y, e n d o s c o p i c debridement, dolleros canal