Two Case of Rino-Orbito-Cerebral Mucormycosis Developing Secondary to Diabetic Ketoacidosis

Mucormycosis is an invasive fungal infection that causes various clinical syndromes, especially in immunocompromised and diabetic patients. The most frequently isolated species are Rhizopus, Mucor, and Rhizomucor. Rhinoorbitocerebral (30%), pulmonary (27%) and cutaneous (26%) forms are most common. In rhinoorbitocerebral mucormycosis (ROCM), inhaled spores are phagocytosed by mononuclear and polymorphonuclear phagocytes, the body’s first defense mechanism. In conditions such as diabetic ketoacidosis, which leads to phagocyte dysfunction, spores invade the vascular endothelium. As a result of angioinvasion, endothelial damage, intravascular thrombosis, vascular occlusion, and severe disease develop after extensive necrosis in infected tissues. In this case report, two diabetic ketoacidosis cases, diagnosed with ROCM are discussed in the light of the literature.