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\begin{document}

\title{Survival of rhino-orbital-cerebral mucormycosis in SARS-COV-}



\author[1]{C. Lädrach}%
\author[2]{Martin  Wartenberg}%
\author[3]{S. Zimmerli}%
\author[1]{Lukas Anschuetz}%
\author[4]{S. Bohlen}%
\author[5]{J. Ebner}%
\author[6]{C. M. F. de Gouyon Matignon de Pontouraude}%
\author[1]{Marco Caversaccio}%
\author[7]{Franca Wagner}%
\affil[1]{Inselspital Universitatsspital Bern Universitatsklinik fur Hals- Nasen- und Ohrenkrankheiten Kopf- und Halschirurgie}%
\affil[2]{Universitat Bern Institut fur Pathologie}%
\affil[3]{Inselspital Universitatsspital Bern Universitatsklinik fur Infektiologie}%
\affil[4]{Inselspital Universitatsspital Bern Universitares Notfallzentrum Erwachsene}%
\affil[5]{Inselspital Bern University Hospital}%
\affil[6]{Inselspital Universitatsspital Bern Universitatsklinik fur Augenheilkunde}%
\affil[7]{Inselspital Universitatsspital Bern Universitatsinstitut fur Diagnostische und Interventionelle Neuroradiologie}%


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  \date{June 15, 2024}


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\begin{abstract}
Rhino-orbital-cerebral mucormycosis (ROCM) is a rare angioinvasive
fungal infection known to be associated with high morbidity and over
50\% mortality and has increased lately due to increasing predisposing
immunocompromising comorbidities as well as COVID-19. In addition to the
common acute disease progression, chronic less aggressive courses have
been described less often. In this paper we report two cases -- a
75-year-old woman with diabetes and a 39-year-old man with recurrent
diabetic ketoacidosis. Both presented initially with acute sinonasal
symptoms, were positive for SARS-COV-2 and later diagnosed with acute
ROCM.~~Both underwent mutilating surgical therapy as well as high
administered dose Amphotericin B and long term continuous antifungal
therapy. Patient 1 showed stable symptoms with radiographically
increasing disease and died of urosepsis 5 months after first surgery.
Patient 2 was first lost to follow-up after repatriation to his home
country and 1 year later sent us a holiday picture of himself, having
recovered from the disease.

\par\null

Key words:

Rhino-orbital-cerebral mucormycosis, mucormycosis, Amphotericin-B,
COVID-19, invasive fungal infection%
\end{abstract}%



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