COVID-19 associated mucormycosis with frontal bone osteomyelitis

During the coronavirus disease 2019 (COVID-19) pandemic, increasing cases of COVID-19 associated mucormycosis (CAM) have been reported. This may be attributed directly to the COVID-19 infection or the associated unrecognised uncontrolled hyperglycaemia compounded by the use of COVID-19 treatment strategies such as steroids and IL-6 inhibitors. As mucormycosis is one of the most rapidly progressing fungal infection, an early diagnosis and early appropriate management are of prime importance in reducing mortality. Rhino-orbital-cerebral and pulmonary mucormycosis have been the most common presentations of CAM. Osteomyelitis in mucormycosis is very rare, although a few cases of maxillary bone involvement have been reported with CAM. We report a very rare and challenging case of extensive frontal bone osteomyelitis in a patient with CAM with frontal sinusitis and without orbital or maxillary bone involvement.
 

Keywords: Covid-19, Mucormycosis, Corticosteroids, Fungal infection, Amphotericin B