Aggressive Mucormycosis in a Systemic Lupus Erythematosus Patient: A Case Report and Treatment Approach

Mucormycosis is a rare, highly aggressive opportunistic fungal infection due to the rapid spread of the pathogen and necrosis of adjacent tissues, often resulting in death. Early diagnosis and prompt clinical and surgical treatment are essential. A 38-year-old female patient with a history of systemic lupus erythematosus presented at Dr. João Lúcio Pereira Machado Hospital and Emergency Room, referred from São Raimundo Emergency Service. She complained of fever, a darkened nasal region associated with itching, and respiratory and visual difficulties. During the physical examination, a necrotic lesion with hyperemic borders on the left nasal ala extending to the hard palate was observed, with hyperemic areas near the teeth of the left hemimaxilla and a whitish lesion suggestive of a necrotic process in the palatine region (Figure 2), leading to a presumptive diagnosis of mucormycosis. Hematological examinations and cranial and facial computed tomography were requested to clarify the case. The evaluation revealed irregular thickening in the subcutaneous cellular tissue, slight mucosal thickening in the left maxillary sinus membrane, and aeration of the middle nasal conchae. The treatment plan adopted included radical surgical debridement with biopsy, antifungal therapy with liposomal Amphotericin B at a daily dose of 08 mg/kg, and admission to the intensive care unit. The aggressive management, involving surgical debridement and antifungal therapy, proved effective for the patient, resulting in a favorable prognosis with no inflammatory or necrotic signs, effectively resolving the case.

Keywords: Mucormycosis; Lupus erythematosus; Treatment approach