Case report reveals mucormycosis in a patient with chronic hepatitis B and D, suggesting medical management is viable when surgery is high risk.
Rhino‐orbital‐cerebral mucormycosis (ROCM) is a rare but highly lethal fungal infection that typically occurs in patients with classical immunosuppressive states. This report presents a case of ROCM in a 27‐year‐old male whose sole systemic risk factor was chronic Hepatitis B (HBV) and Hepatitis D (HDV) coinfection. The patient presented with advanced disease, including nasal necrosis and progressive periorbital swelling. Advanced imaging revealed extensive intraorbital and intracranial invasion with significant mass effect, a finding that rendered the standard‐of‐care surgical debridement prohibitively high risk. A definitive diagnosis was established via histopathology. Consequently, a deliberate decision was made to proceed with exclusive medical management. The patient was treated successfully with high‐dose intravenous liposomal amphotericin B monotherapy, resulting in a favorable clinical outcome. This case establishes chronic viral hepatitis as a significant non‐classical risk factor for ROCM and provides critical evidence that aggressive medical monotherapy can serve as a definitive, life‐saving treatment when the standard bimodal surgical approach is contraindicated.
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Bibi et al. (2025) studied this question.
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