{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:17:09Z","timestamp":1780507029331,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Central nervous system (CNS) mucormycosis is a rare, life-threatening fungal infection predominantly affecting diabetic and immunocompromised patients. Early diagnosis remains challenging, resulting in poor outcomes. We report a case highlighting the diagnostic challenges and rapid progression in a patient with uncontrolled diabetes and COVID-19 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 31-year-old male with untreated type 2 diabetes mellitus presented with severe pneumonia due to COVID-19 infection. His condition rapidly deteriorated, developing CNS symptoms and characteristic nasal lesions. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, high protein, and low glucose. Metagenomic next-generation sequencing (mNGS) of CSF confirmed <jats:italic>Rhizopus oryzae<\/jats:italic> infection. Despite initiating amphotericin B therapy, his condition worsened.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient succumbed to progressive multi-organ failure secondary to disseminated mucormycosis. This case emphasizes the significance of uncontrolled diabetes and COVID-19 as critical risk factors and highlights the diagnostic utility of CSF mNGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prompt recognition of risk factors, early utilization of advanced diagnostic methods, and aggressive treatment are essential to improve outcomes in CNS mucormycosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1596136","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T04:15:49Z","timestamp":1746504949000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Diabetes-associated central nervous system mucormycosis with delayed diagnosis: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Geng","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changchun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1007\/s15010-021-01670-1","article-title":"COVID-19 and mucormycosis superinfection: the perfect storm","volume":"49","author":"Al-Tawfiq","year":"2021","journal-title":"Infection."},{"key":"B2","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.cmi.2018.07.011","article-title":"The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports","volume":"25","author":"Jeong","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"B3","doi-asserted-by":"publisher","first-page":"102146","DOI":"10.1016\/j.dsx.2021.05.019","article-title":"Mucormycosis in COVID-19: a systematic review of cases reported worldwide and in India","volume":"15","author":"Singh","year":"2021","journal-title":"Diabetes Metab Syndr."},{"key":"B4","doi-asserted-by":"publisher","first-page":"944.e9","DOI":"10.1016\/j.cmi.2019.11.021","article-title":"A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India","volume":"26","author":"Patel","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1111\/myc.13353","article-title":"Mucormycosis and COVID-19: an epidemic within a pandemic in India","volume":"64","author":"Selarka","year":"2021","journal-title":"Mycoses."},{"key":"B6","doi-asserted-by":"publisher","first-page":"117325","DOI":"10.1016\/j.jns.2021.117325","article-title":"Cns Fungal Infections: A Review","volume":"422","author":"Nathan","year":"2021","journal-title":"J Neurol Sci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"319","DOI":"10.3390\/medicina55070319","article-title":"Invasive and non-invasive fungal rhinosinusitis-a review and update of the evidence","volume":"55","author":"Deutsch","year":"2019","journal-title":"Medicina."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e1006408","DOI":"10.1371\/journal.ppat.1006408","article-title":"Molecular mechanisms of mucormycosis-the bitter and the sweet","volume":"13","author":"Baldin","year":"2017","journal-title":"PLoS Pathog."},{"key":"B9","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1007\/s12663-021-01532-1","article-title":"Sars-Cov-2, uncontrolled diabetes and corticosteroids-an unholy trinity in invasive fungal infections of the maxillofacial region? 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