{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:09:05Z","timestamp":1753862945445,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Immunosuppression from B\u2010acute lymphoblastic leukemia (B\u2010ALL) chemotherapy and a preceding COVID\u201019 infection may predispose patients to rare complications such as rhino\u2010orbital mucormycosis. Hence, a high index of suspicion should be maintained by physicians (and oncologists) if patients undergoing B\u2010ALL treatment present with orofacial symptoms and ophthalmological manifestations such as peri\u2010orbital swelling, ophthalmoplegia, and loss of vision, suggestive of infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Mucormycosis is a severe fungal infection that poses significant mortality and morbidity risks, particularly in immunocompromised individuals. We present a rare case of a 16\u2010year\u2010old patient with rhino\u2010orbital mucormycosis following B\u2010acute lymphoblastic leukemia (B\u2010ALL) treatment and concurrent COVID\u201019 infection. We describe the clinical presentation, diagnosis, treatment, and outcome of this patient, and discuss the possible interactions and implications of these three conditions. A young 16\u2010year\u2010old male patient without significant clinical history was admitted with complaints of low\u2010grade intermittent fever, fatigue, malaise, restlessness, and unexplained weight loss for the past 2\u2009months. A bone marrow biopsy confirmed the diagnosis of B\u2010ALL. Following the diagnosis of B\u2010ALL, the patient underwent initiation of chemotherapy. Following the initial two cycles of chemotherapy, the patient experienced fever and cough and tested positive for COVID\u201019 infection. Nearly a week later, the patient presented to the chemotherapy emergency department with a clinical picture characterized by a fever up to 39\u00b0C associated with left facial swelling, severe headache, purulent rhinorrhea, and foreign body sensation in the ipsilateral nostril. The following day, erythema and left eyelid edema were observed, with ocular opening limitation. The diagnosis was confirmed based on the positive result of polymerase chain reaction for left\u2010sided mucormycosis. Initial administration of liposomal and lipid amphotericin B at 1\u20131.5\u2009mg\/kg\/d doses for 4\u20136\u2009weeks was followed by surgical debridement of necrotic tissue on the left side of the face and nose. Subsequent ophthalmological examinations showed normal conditions of the left eye. The case underscores the importance of heightened clinical suspicion, early diagnosis through imaging and molecular techniques, aggressive multimodal therapy, and close interdisciplinary collaboration for improved outcomes in such rare and challenging clinical scenarios.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.8972","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T03:59:38Z","timestamp":1716523178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Co\u2010occurrence of rhino\u2010orbital mucormycosis and acute lymphoblastic leukemia <scp>post\u2010COVID<\/scp>\u201019 infection in a young adolescent male: A case report from a low middle\u2010income country"],"prefix":"10.1002","volume":"12","author":[{"given":"Maneesha","family":"Lingarapu","sequence":"first","affiliation":[{"name":"Government Medical College  Mahabubnagar India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bisma","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Jinnah Sindh Medical University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4090-5393","authenticated-orcid":false,"given":"Ajeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa Ahmed","family":"Khan","sequence":"additional","affiliation":[{"name":"Jinnah Hospital  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9635-9891","authenticated-orcid":false,"given":"Malik Olatunde","family":"Oduoye","sequence":"additional","affiliation":[{"name":"Department of Research The Medical Research Circle  Goma North Kivu Democratic Republic of Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6405-9004","authenticated-orcid":false,"given":"Nancy","family":"Kamboj","sequence":"additional","affiliation":[{"name":"Pt. B.D.Sharma Postgraduate Institute of Medical Sciences  Rohtak Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-283X","authenticated-orcid":false,"given":"Mahmood","family":"Danishwar","sequence":"additional","affiliation":[{"name":"Reading Hospital\u2014Towerhealth  Reading Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mmcr.2022.10.005"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.53854\/liim-3002-17"},{"issue":"8","key":"e_1_2_13_4_1","first-page":"1068","article-title":"The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM\u20102004 study","volume":"91","author":"Pagano L","year":"2006","journal-title":"Haematologica"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13151"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.10.034"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.10.011"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir866"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.9610"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.949910"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.13.78"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myx101"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10184110"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9123973"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14040429"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2022.42.312.34757"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s100960100528"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0b013e3181dde8fc"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T06:41:04Z","timestamp":1720680064000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,23]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/ccr3.8972"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8972","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2024,5,23]]},"assertion":[{"value":"2024-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8972"}}