Necrotising Fasciitis Complicating Rhino Orbito Cerebral Mucormycosis – A Case Report

Abstract

Introduction: Mucormycosis became a common life-threatening fungal infection during the COVID-19 Delta variant wave in India. These fungi have an intrinsic ability to invade blood vessels. Rhino-orbito-cerebral mucormycosis is the most common and most aggressive form of mucormycosis. Uncontrolled metabolic conditions, especially diabetes mellitus with ketoacidosis, are the principal risk factors, and mortality remains high (30–70%) despite advances in diagnosis and treatment.

Clinical Discussion: This report describes the first documented case of monomicrobial necrotising fasciitis caused by Pseudomonas aeruginosa secondary to rhino-orbito-cerebral mucormycosis. The authors detail the patient's management, including extensive surgical debridement, prolonged antifungal and antibiotic therapy, reconstructive procedures, and the challenges posed by multidrug-resistant Pseudomonas infection.