CASE REPORT article

Front. Neurol.

Sec. Neuroinfectious Diseases

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1596136

Diabetes-Associated Central Nervous System Mucormycosis with Delayed Diagnosis

Provisionally accepted
Geng  JiaGeng JiaChangchun  YangChangchun YangYi  FengYi Feng*
  • First People's Hospital of Changzhou, Changzhou, China

The final, formatted version of the article will be published soon.

Background: Central nervous system (CNS) mucormycosis is a rare,life-threatening 4 fungal infection predominantly affecting diabetic and immunocompromised patients. 5 Early diagnosis remains challenging, resulting in poor outcomes. We report a case 6 highlighting the diagnostic challenges and rapid progression in a patient with 7 uncontrolled diabetes and COVID-19 infection. Case Presentation: A 31-yearold male with untreated type 2 diabetes mellitus 13 presented with severe pneumonia due to COVID-19 infection. His condition rapidly 14 deteriorated, developing CNS symptoms and characteristic nasal lesions. Cerebrospinal 15 fluid (CSF) analysis revealed lymphocytic pleocytosis, high protein, and low glucose. 16 Metagenomic next-generation sequencing (mNGS) of CSF confirmed Rhizopus oryzae 17 infection. Despite initiating amphotericin B therapy, his condition worsened. Results: The patient succumbed to progressive multi-organ failure 26 secondary to disseminated mucormycosis. This case emphasizes the significance of 27 uncontrolled diabetes and COVID-19 as critical risk factors and highlights the 28 diagnostic utility of CSF mNGS. Conclusion: Prompt recognition of risk factors, early utilization of advanced diagnostic 34 methods, and aggressive treatment are essential to improve outcomes in CNS 35 mucormycosis.

Keywords: MucormycosisRhizopus oryzae, Central Nervous System InfectionCNS mucormycosis, Diabetes Mellitus, Diabetic Ketoacidosis, early diagnosis, Delayed DiagnosisNasal lesion

Received: 21 Mar 2025; Accepted: 14 Apr 2025.

Copyright: © 2025 Jia, Yang and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yi Feng, First People's Hospital of Changzhou, Changzhou, China

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