Rhino‐Orbital‐Cerebral Mucormycosis in a Patient With Chronic Hepatitis B and D Coinfection: A Rare Case Report

Abstract

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.