Work

Diabetes-associated central nervous system mucormycosis with delayed diagnosis: a case report

Year: 2025

Type: article

Abstract: Background Central nervous system (CNS) mucormycosis is a rare, life-threatening fungal infection predominantly affecting diabetic and immunocompromised patients. Early diagnosis remains challenging, resulting in poor outcomes. We report a case highlighting the diagnostic challenges and rapid progression in a patient with uncontrolled diabetes and COVID-19 infection. Case presentation A 31-year-old male with untreated type 2 diabetes mellitus presented with severe pneumonia due to COVID-19 infection. His condition rapidly deteriorated, developing CNS symptoms and characteristic nasal lesions. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, high protein, and low glucose. Metagenomic next-generation sequencing (mNGS) of CSF confirmed Rhizopus oryzae infection. Despite initiating amphotericin B therapy, his condition worsened. Results The patient succumbed to progressive multi-organ failure secondary to disseminated mucormycosis. This case emphasizes the significance of uncontrolled diabetes and COVID-19 as critical risk factors and highlights the diagnostic utility of CSF mNGS. Conclusion Prompt recognition of risk factors, early utilization of advanced diagnostic methods, and aggressive treatment are essential to improve outcomes in CNS mucormycosis.

Source: Frontiers in Neurology

DOI: 10.3389/fneur.2025.1596136

Authors: Geng Jia, Changchun Yang, Yi Feng

Institution: The First People's Hospital of Changzhou

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801