Rhino-Orbital Mucormycosis in a Postpartum Diabetic Patient: An Atypical Presentation of Oral Ulcers and Facial Swelling

TL;DR

A postpartum diabetic woman developed a rare fungal infection with oral ulcers and facial swelling, highlighting the need for early diagnosis in high-risk patients.

Contribution

This case report presents an atypical postpartum presentation of rhino-orbital mucormycosis, suggesting a potential link to obstetric-related immunosuppression.

Findings

The patient had extensive necrotic lesions and MRI confirmed rhino-orbital mucormycosis.

Treatment included liposomal amphotericin B, glycemic control, and surgical debridement.

The case suggests a possible association between postpartum immunosuppression and invasive fungal infections.

Abstract

Mucormycosis is a rare, life-threatening fungal infection primarily affecting immunocompromised individuals, particularly those with poorly controlled diabetes mellitus. This case report presents a 40-year-old female with a decade-long history of uncontrolled type 2 diabetes who developed progressively worsening oral ulcers, facial swelling, and vomiting, following a recent stillbirth. The patient exhibited extensive necrotic lesions involving the nose, oropharynx, and soft palate, leading to a high suspicion of invasive fungal infection. Diagnostic imaging with magnetic resonance imaging (MRI) revealed extensive sinus and orbital involvement, while histopathological examination confirmed rhino-orbital mucormycosis. The patient was managed with liposomal amphotericin B, strict glycemic control, and surgical debridement to remove necrotic tissue. This case underscores the importance of early recognition and multidisciplinary management of mucormycosis, particularly in atypical presentations involving postpartum immunosuppression. Given the rising incidence of invasive fungal infections, clinicians must maintain a high index of suspicion in high-risk patients, especially those with uncontrolled diabetes. Awareness of mucormycosis and its varied clinical presentations can aid in timely diagnosis and improve patient outcomes. The report highlights a unique presentation in a postpartum female, suggesting a potential link between obstetric complications and invasive fungal infections, warranting further research into postpartum-related immunosuppression as a risk factor.

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