Introduction
In the early 2021 started with mutation of SARS CoV2 and emergence of
B.1.617.1 or Delta variant leading to a deadly resurgence of the
disease. This highly virulent strain led to increased mortality due to
its high infectivity and virulence1. Outbreak of new
opportunistic infection mucormycosis was seen among the post covid
patients. These secondary fungal infections or coinfections are critical
challenges increasing the patient’s morbidity and mortality. India has
reported the highest number of mucormycosis cases in the world,
especially following the second wave of the pandemic2.
Mucormycosis was declared as an epidemic by the Government of
India3 due to surge in the cases. The mucormycosis was
managed effectively by surgical debridement along with systemic
amphotericin B through the multidisciplinary teams in hospitals across
India4. Now, following the initial treatment of
mucormycosis there is a resurgence, in the form of fungal osteomyelitis
of the frontal bone. This form of presentation has not been previous
recognized, with only a very few case reports describing it. The
resurgence of this disease is attributed to the incomplete clearance,
inadequate amphotericin dosing, comorbidities, immune status and
previous disease extent4,5.
Here in this article, we describe the presentation, clinical features,
radiological, intraoperative findings, and post operative outcomes
following the management of frontal osteomyelitis of fungal origin.