Abstract / Summary
Abstract Background: Mucormycosis is an invasive fungal infection, typically seen in immunocompromised patients. Primary tubo-ovarian involvement is extremely rare, especially among adolescents with no known immunodeficiency. We present a case of primary tubo-ovarian mucormycosis in an apparently immunocompetent adolescent female. Case Presentation: A 17-year-old female presented with a 3-4 months history of lower abdominal pain, intermittent high-grade fever, weight loss, and progressively increasing right adnexal mass. Investigations showed raised white cell count, elevated inflammatory markers, and a mild increase in CA-125 levels. Imaging studies were indicative of tubo-ovarian abscess. Laparotomy revealed a complex right tubo-ovarian mass containing 500 ml of pus. Microscopic findings revealed ovarian abscess formation with severe fungal infection and strongly positive PAS stain, suggesting mucormycosis. Amphotericin B caused side effects; hence, voriconazole was administered as other options were not available. Although there was improvement in clinical condition, the presence of adnexal mass and recurrence of symptoms and renal dysfunction required radical excision surgery. Conclusion: Primary tubo-ovarian mucormycosis can be encountered in apparently immunocompetent adolescents and might mimic tubo-ovarian abscess. Prompt histologic diagnosis, effective antifungal therapy for Mucorales and radical surgery play a significant role in successful management.