Diagnostic Challenges in Rhino-Orbito-Cerebral Mucormycosis With Diabetes Mellitus, Hypertensive Emergency, and Excess Alcohol Consumption

A 72-year-old male with a history of excessive alcohol intake (35+ units of alcohol daily) presented to the emergency department with bilateral vision loss, periorbital swelling, headache, and sinus congestion with bloody nasal discharge. He was newly diagnosed with diabetes mellitus and presented with severe diabetic ketoacidosis and a hypertensive emergency (blood pressure of 240/90 mmHg). Despite initial normal brain and orbital imaging, the clinical presentation was complicated by multiple life-threatening conditions and a prior immunocompetent status, thereby delaying the early suspicion of mucormycosis. This case underlines the diagnostic challenges in managing mucormycosis in a previously immunocompetent patient with overlapping critical conditions.