Diagnostic Challenges and Multidisciplinary Management in an atypical presentation of Mucormycosis

Mucormycosis is an invasive fungal infection, rare but highly lethal, caused by fungi of the Mucoraceae family. It primarily affects immunocompromised patients, particularly those with poorly controlled diabetes mellitus, leukemia, transplants, or those receiving immunosuppressive therapy. Its most common form is rhinocerebral mucormycosis, characterized by rapid progression and vascular invasion, leading to thrombosis and tissue ischemia. The aim of this study was to analyze the clinical, microbiological, and therapeutic approach implemented in an atypical case of rhino-orbital mucormycosis in an immunocompromised patient, emphasizing the importance of early diagnosis, microbiological sample processing, and the effectiveness of a comprehensive interdisciplinary management in achieving a favorable outcome. We report the case of a 61-year-old female patient with poorly controlled diabetes who presented with orbital cellulitis, visual loss, and a necrotic palatal ulcer. The diagnosis was established through physical examination, computed tomography, histopathological studies, fungal culture, and specific stains such as KOH and calcofluor white. Treatment included liposomal amphotericin B from the first day of hospitalization, multiple surgical interventions (antrostomy, sphenoidectomy, tracheostomy, and palatal favorably, with complete mucosal healing and no residual bone damage, and was discharged under outpatient follow- up. The combination of early diagnosis, timely antifungal therapy, and appropriate surgical managementsignificantly improves the prognosis of mucormycosis. Atypical presentations, such as palatal necrosis without bone involvement, highlight the importance of a multidisciplinary approach and active clinical vigilance. Microscopy, culture, and molecular techniques are complementary tools in the diagnosis of this severe infection.