Two Uncommon Presentations of COVID-19-Associated Mucormycosis

Mucormycosis is a rare opportunistic fungal infection commonly affecting immunocompromised individuals. There has been a surge in the number of these cases during the second wave of the Coronavirus Disease 2019 (COVID-19) in India. Mucormycosis has been reported to occur concurrently or a few weeks post-recovery from COVID-19. There have been multiple case reports/case series of rhino-orbital mucormycosis in India as a complication in COVID-19 pneumonia. We report two unique presentations of COVID-19-associated mucormycosis (CAM) in patients recently recovered from COVID-19. The first patient is an uncontrolled diabetic with Fournier's gangrene at presentation, which on further evaluation, showed features of mucormycosis. The second one is a case of uncontrolled diabetes with a previous COVID-19 infection presenting with pulmonary mucormycosis and aspergillosis, complicated by a gastropleural fistula. While liposomal amphotericin B (L-ampB) was started for both patients, they significantly deteriorated during their course of hospital stay due to the severity of the disease.