Mucormycosis complicating diabetes mellitus and COVID-19: a diagnostic and therapeutic threat

Sophia Amalanathan, Kumaran Ramesh Colbert, Satish Kumar Chockalingam, Sankappa Pundalikappa Sinhasan, Chaitra Jadhav


COVID-19 infections is known to have a multitude of clinical presentations, and newer clinical complications continue to be reported from all over the world. It is now widely known that the diabetic patients with poor glycemic control are associated with a higher risk of developing severe COVID-19 infection. They are also at a high risk for developing secondary bacterial or fungal, co infections because of the complex interplay of multiple risk factors , necessitating an intensive medical care and monitoring in them. We are presenting a case of mucormycosis in a diabetic patient with moderate COVID pneumonia that presented to us as orbital cellulitis and the events that followed. There have been very few documented cases of mucormycosis in COVID infected diabetic patients so far during this pandemic and we also present a literature review of the same.


COVID-19, Diabetes mellitus, Orbital cellulitis, Mucormycosis

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COVID-19 INDIA as on 2020. Available at: Accessed on 21st December, 2020.

Azer SA. COVID-19: Pathophysiology, diagnosis, complications and Investigational therapeutics. New Microbes and New Infections. 2020;100738.

Terpos E. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95:834-847.

Filatov A, Sharma P, Hindi F, Espinosa PS. Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy. Cureus. 2020;21:12(3):e7352.

Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A et al. Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metab Syndr. 2017;9:8.

Maddaloni E, Buzzetti R. COVID-19 and diabetes mellitus: unveiling the interaction of two pandemics. Diabetes Metab Res Rev. 2020;:e33213321.

Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia. 2020;185:599-606.

Mehta S, Pandey A. Rhino-Orbital Mucormycosis Associated With COVID-19. Cureus. 2020;12(9):e10726.

Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med. 2020;20:S0735-6757.

Tang Y, Liu J, Zhang D, Xu Z, Ji J, Wen C. Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies. Front Immunol. 2020;11:1708.

COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. National Institutes of Health. 2020. Available at: Accessed on 21st December, 2020.

Thomas L, Tay SY, Howard D, Falhammar H. Mucormycosis in a 40-year-old woman with diabetic ketoacidosis. CMAJ. 2020;192(16):E431-E433.

Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;e3319.

Matteo A. COVID-19 in People With Diabetes: Understanding the Reasons for Worse Outcomes." The Lancet. Diabetes Endocrinol. 2020;8(9):782-792.

Bhansali A, Bhadada S, Sharma A, Suresh A, Gupta A, Singh P et al. Presentation and outcome of rhino-orbital-cerebral mucormycosis in patients with diabetes. Postgrad Med J. 2004;80:670-674.