Mucormycosis

Mucormycosis is an invasive infection caused by fungi in the order Mucorales, including Rhizopus, Mucor, and Lichtheimia. These organisms are environmental moulds, but in a susceptible host they can progress rapidly from a local infection to vascular invasion, infarction, and tissue death. The highest-risk patient is often one with diabetic ketoacidosis, but the pattern also occurs with uncontrolled diabetes, neutropenia or hematologic malignancy, stem-cell or solid-organ transplantation, prolonged systemic corticosteroid therapy, iron overload, deferoxamine exposure, or severe COVID-19. The experienced nurse notices the combination of host risk and a rapidly progressive focal finding rather than waiting for a dramatic single symptom. Rhinocerebral disease commonly begins in the sinuses. Unilateral facial pain, nasal congestion, bloody or dark discharge, facial swelling, or a necrotic lesion on the nasal mucosa or hard palate should prompt urgent escalation. Proptosis, impaired eye movement, new diplopia, cranial nerve deficits, or altered mental status suggest orbital or intracranial extension. Black eschar represents tissue infarction from vascular invasion, but its absence does not exclude mucormycosis. Pulmonary disease may present with fever, cough, pleuritic pain, hemoptysis, dyspnea, or worsening...