Abstract

Mucormycosis is a rare and rapidly progressive fungal infection associated with high mortality, particularly among immunocompromised individuals. Solid organ transplant recipients remain at risk not only during the early posttransplant period but also during episodes of intensified immunosuppression for rejection. We report the case of a 14-year-old female liver transplant recipient who developed rhino-orbitocerebral mucormycosis that was initially misdiagnosed as a dental abscess and orbital cellulitis. Early clinical suspicion, prompt histopathological confirmation, aggressive surgical management—including enucleation and partial maxillectomy—and prolonged antifungal therapy (liposomal amphotericin B followed by posaconazole) resulted in survival despite cerebral involvement. At 18 months posttransplantation, the patient remains alive and continues antifungal therapy, with radiologically stable residual lesions. This case highlights the importance of maintaining a high index of suspicion, ensuring early diagnostic confirmation, and implementing prolonged, individualized antifungal therapy to achieve favorable outcomes in liver transplant recipients with cerebral mucormycosis.