Abstract This is a case of a young male with chronic pancreatitis in whom a delayed diagnosis of type I diabetes mellitus and rhino-orbital mucormycosis led to cerebral involvement and the need for orbital exenteration and partial temporal lobectomy. Therapeutic levels of posaconazole could not be achieved due to multiple factors, including fat malabsorption secondary to chronic pancreatitis. Hence, therapy was switched to isavuconazole despite high MICs. The case has in it several messages, including the role of combination therapy, antifungal susceptibility testing of Mucorales , therapeutic drug monitoring, and radiologic follow-up of mucormycosis.
Singhal et al. (Thu,) studied this question.