Rhino–orbito–cerebral mucormycosis following penetrating keratoplasty

Rhino–orbito–cerebral mucormycosis (ROCM) is a potentially devastating fungal infection with a significant fatality rate. Early diagnosis and prompt management are crucial to ensure a favorable outcome due to the recognized rapid progression. This case is a rare presentation of ROCM in a patient with uncontrolled diabetes following a corneal transplant. The procedure required early surgical resection in the first 30 hours of hospitalization. The patient received wide-spectrum antibiotics and antifungal treatment and underwent extensive debridement of the necrotic area. A high index of suspicion is needed to diagnose ROCM. Any diabetic patient with sinonasal disease and/or cranial nerve involvement, irrespective of their serum glucose or glycated hemoglobin levels, is a candidate for prompt evaluation to exclude mucormycosis. The rapid evolution of our case highlights the importance of treating ROCM promptly and aggressively.