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Invasive nasal and paranasal mucormycosis in a patient with severe dengue fever and multiple risk factors: A case report and literature review

Summary

A 50-year-old woman in Vietnam developed a rare and deadly fungal infection called mucormycosis while recovering from dengue fever. She had weakened immunity from taking steroids for other conditions and from the dengue virus itself. The infection caused black, dead tissue to rapidly spread in her nose and around her eye. Despite treatment with antifungal medications, the infection progressed, and she died within days. The case shows how important it is to watch for dangerous opportunistic infections in dengue patients, especially those already dealing with weakened immune systems.

Background

Mucormycosis is a rare, life-threatening opportunistic fungal infection with high mortality rates affecting immunocompromised patients. The co-occurrence of dengue fever and mucormycosis is extremely rare globally. This case represents the first documented case of invasive rhino-orbital mucormycosis following severe dengue fever in Vietnam.

Objective

To report and describe the clinical characteristics, diagnosis, treatment course, and outcomes of a patient with invasive nasal and paranasal mucormycosis developing during severe dengue fever with multiple concomitant risk factors. The report aims to emphasize the importance of monitoring for opportunistic infections in dengue patients.

Results

A 50-year-old female with rheumatoid arthritis, secondary adrenal insufficiency, and recent COVID-19 infection developed severe dengue fever with shock and progressive invasive mucormycosis of the nasal and paranasal regions. Histopathology confirmed mucormycosis with characteristic non-septate hyphae and right-angle branching. Despite amphotericin B therapy, the patient showed no clinical improvement and died after two days of treatment without surgical debridement.

Conclusion

Mucormycosis is a rare but serious complication in dengue fever patients with multiple immunocompromising risk factors. Early recognition and aggressive treatment combining both antifungal therapy and surgical debridement are essential. This case emphasizes the need for close monitoring of immunocompromised dengue patients for opportunistic fungal infections.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40822863, DOI: 10.1016/j.mmcr.2025.100724
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