2025 Clinician Corner - Isolated orbital mucormycosis in the setting of COVID-19 pneumonia

Abstract 

Mucormycosis is a fungal infection most commonly affecting severely ill patients, with increasing incidence in the setting of the COVID-19 pandemic. Due to its ability to involve multiple structures including the paranasal sinuses, orbit, and brain, mucormycosis infections present with variable clinical signs. All previously reported cases of mucormycosis in the literature involved paranasal sinus involvement, most commonly the ethmoid sinus. Herein we present the first reported case of isolated orbital mucormycosis without histologic evidence of paranasal sinus infection. Prompt recognition of atypical mucormycosis infections in the absence of paranasal sinus involvement in critically ill patients is necessary in order to initiate early and aggressive treatment due to the high fatality rate and rarity of this presentation.   

Keywords:  COVID-19; mucormycosis; orbit; orbital cellulitis

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Faculty credentials/disclosure 

The planners and faculty for this activity have no relevant financial relationships to disclose. The patient consented to the publication of this report.

Process

Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

  • By completing this process, you are attesting that you have read the journal article.

Expiration date:

Credit eligibility for this article is set to expire on November 1, 2026.

Learning Objectives

After completing the article, the learner should be able to:

  • Identify clinical signs concerning for mucormycosis in order to initiate prompt medical and surgical treatment. 
  • Formulate an appropriate treatment plan for patients with orbital involvement of mucormycosis infection 

Key Points 

  • Mucormycosis is an invasive fungal infection primarily affecting severely ill patients and may involve the paranasal sinuses, orbit, and brain. 
  • Despite aggressive medical and surgical intervention, mucormycosis infections may be fatal. 
  • It is important to consider mucormycosis in the differential diagnosis in atypical presentations to initiate prompt treatment. 

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Course summary
Available credit: 
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
11/01/2025
Course expires: 
11/01/2026
Cost:
$25.00
Rating: 
0
  • Kimberly K. Nguyen, MD - Department of Ophthalmology and Department of Oculofacial Plastic, Orbital, and Reconstructive Surgery, Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon, USA 
  • John D. Ng, MD, MS - Department of Ophthalmology and Department of Oculofacial Plastic, Orbital, and Reconstructive Surgery, Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon, USA 

Corresponding author: John D. Ng, MD, MS, Casey Eye Institute, Oregon Health and Science University, 515 SW Campus Drive, Portland, OR 97239 (e-mail: [email protected]) 

The planners and faculty for this activity have no relevant financial relationships to disclose. This study was supported by an unrestricted grant from Research to Prevent Blindness, New York, NY, NIH P30 EY010572 Core Grant, and the Malcolm M. Marquis, MD Endowed Fund for Innovation to Casey Eye Institute, Oregon Health & Science University. The patient consented to publication of this case report. 

Accreditation

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation

AMA PRA Category 1 Credit™

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS CC

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

ABIM MOC

 Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

 

Available Credit

  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance

Price

Cost:
$25.00
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