Clinical course and diagnosis of cerebral vein and sinus thrombosis associated with COVID-19 in young and middle-aged patients.

Cerebral venous thrombosis (CVT) is a form of cerebrovascular disorders that is difficult to recognize, it is potentially a life threatening condition and requires timely anticoagulant therapy. In the era of the COVID-19 pandemic, there is a steady increase in CVT (4.2% vs. 0.5-1%). At the same time, mortality in patients with CVT on the background of COVID-19 significantly exceeds the mortality in patients with CVT without COVID-19 (45.5% vs. 15%). Objective(s): to study the clinical course of CVT, to determine the diagnostic value of radiological methods and the significance of genetic risk factors for thrombosis in the development of CVT in young and middle-aged patients against the background of COVID-19. Material and methods. Seven patients were examined: six women (five of them of reproductive age) and one man, aged 26 to 57 years (mean age 37 years). The main clinical and neurological manifestations of CVT, the results of laboratory examination, neuroimaging, and the data of molecular genetic analysis of risk factors for thrombosis were analyzed. Results. The course of COVID-19 was severe in one case, and moderate in the rest of cases. The interval between the onset of COVID-19 symptoms and the development of CVT ranged from 7 to 25 days. In three cases CVT had an acute course and was accompanied by the development of a stroke (in two cases, hemorrhagic stroke was noted, in one case, multifocal ischemic stroke), in other cases, a subacute course of CVT was noted. Genetic risk factors for thrombosis were identified in all patients. Conclusion. The diagnosis of CVT in the era of the COVID-19 pandemic is particularly difficult, since the most common symptom of CVT - headache (90%) - can be regarded as a manifestation of COVID-19. At the same time, timely diagnosis of CVT and immediate initiation of anticoagulant therapy are associated with a relatively favorable prognosis.Copyright © 2023 Ima-Press Publishing House. All rights reserved.

COVID Associated Invasive Aspergillosis.

To study the possible association between invasive fungal sinusitis (aspergillosis) and coronavirus disease. An observational study was conducted at a tertiary care centre over 6 months, involving all patients with aspergillosis of the paranasal sinuses suffering from or having a history of COVID-19 infection. 92 patients presented with aspergillosis, all had an association with COVID-19 disease. Maxillary sinus (100%) was the most common sinus affected. Intraorbital extension was seen in 34 cases, while intracranial extension was seen in 5 cases. Diabetes mellitus was present in 75 of 92 cases. All had a history of steroid use during their coronavirus treatment. New manifestations of COVID-19 are appearing over time. The association between coronavirus and aspergillosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and overzealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.

Trends in sinusitis

Every cough and sniffle raises red flags in a clinical area that already was a drain on health care resources. Prescribing antibiotics may give patients a peace of mind regarding their symptoms, but Carnazzo says 75% of her patients don't return for a prescription after a bit of education about what to expect and what is normal in terms of symptoms and progression of sinusitis. Besides education, she says offering patients an alternative for symptom management can help. [...]things like promoting crying, exposure to cold weather, and anything else that can help make the nose run works well, she says.

Risk Factors for Procurence of Mucormycosis and its Manifestations Post Covid-19: a Single Arm Retrospective Unicentric Clinical Study.

To assess the risk factors causative of ROCM post COVID-19. To determine the clinical manifestations, causative factors leading to surge in ROCM & factors contributing to poor prognosis in ROCM cases occurring in Western Rajasthan post COVID-19. In a Retrospective observational study, 56 post COVID-19 ROCM patients were analyzed from 'May-June 2021' at M.D.M. Hospital, Jodhpur. All patients after onset of disease were assessed as per selection criteria, included patients were examined for risk factors and clinical manifestations & then were statistically evaluated. Median age was 53 years with male to female ratio 2.7:1. Uncontrolled diabetes was noted in at least 85% patients. Steroid use was seen in 66%. Other major contributing factor to ROCM was the occupation; Out of 56 patients 69% were FARMERS.72% had no history of COVID-19 vaccination. Only 3% had no underlying disease. Overall mortality rate was 16% .2 determinants were associated with poor prognosis: higher HbA1c-Out of 7 cases of orbital exenteration, 6 (85%) had HbA1c > 12. 36% took immoderate amounts of Steam inhalation. Maxillary sinuses were the most involved sites (94%). Orbital involvement was seen in 33 and 12% were PL negative. Palatal involvement & intracranial involvement were seen in 14% and 7% respectively. Bilateral disease was seen in 28%. Uncontrolled DM & Humid working conditions came out to be the main predisposing factors for ROCM. Facial pain is considered to be the most common presenting complain. Maxillary sinus is the most involved site.

Approach to Sinonasal Masses: A Comprehensive Review

The complex anatomy and exposure to various potential carcinogens lead to the development of tumors and tumor-like pathologies of the nose and paranasal sinuses. Delays in the diagnosis of sinonasal masses are common, leading to significant morbidity and mortality. Often the radiologist is the first person to recognize a neoplasm in a suspected inflammatory condition. Computed tomography and magnetic resonance imaging play a synergistic role in the assessment of pathologies in the sinonasal region, and their importance has become increasingly prevalent in the current scenario of coronavirus disease 2019 associated mucormycosis. Besides, imaging is essential for mapping the exact extent of the pathology and delineating vascular supply of hypervascular masses, thus facilitating the operating surgeon and interventional radiologist in management. The cases presented in this article have been accrued over the past three decades and analyzed as a retrospective observational study, with clinical, radiological, and pathological data having been extracted from the existing database in the institution. We present the imaging spectrum of sinonasal masses in the pediatric and adult population, highlight the key radiological features of the common pathologies and discuss an imaging template for reporting these masses, with special focus on the surgically relevant points to be included in the report. The educational goal of this review is to explore a meticulous and systematic imaging approach toward soft tissue lesions in the sinonasal region, which would enable the radiologist to reach a diagnosis or point toward the possible etiology and nature of the lesions.

RADIOLOGY OF RHINOORBITOCEREBRAL MYCORMYCOSIS IN PATIENTS AFTER COVID-19

Purpose. The analysis of CT and MR patterns of rhinoorbitocerebral mucormycosis (ROCM) among patients with type 2 diabetes (T2D) after COVID-19. Materials and methods. The study included 11 patients with confirmed COVID-19 and invasive ROCM in the long-term period. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Results. We report several CT and MR patterns for a series of patients: involvement of paranasal sinuses, orbits, optic nerves, large arteries;intracranial spread;involvement bones of cranial base. The features of differential diagnosis and recommendations for standard protocols are presented. Conclusion. CT of paranasal sinuses is the method of choice for suspected fungal infections. MRI is recommended if there is a suspicion of orbital, vascular, and intracranial complications or cavernous sinus extension. The combination of both methods makes it possible to showed soft tissue invasion and bony destruction to choose optimal medical tactics ROCM. © 2022 Russian Electronic Journal of Radiology. All rights reserved.

Prediction and Analysis of Heart Diseases Using Heterogeneous Computing Platform

The work in this paper helps study cardiac rhythms and the electrical activity of the heart for two of the most critical cardiac arrhythmias. Various consumer devices exist, but implementation of an appropriate device at a certain position on the body at a certain pressure point containing an enormous number of blood vessels and developing filtering techniques for the most accurate signal extraction from the heart is a challenging task. In this paper, we provide evidence of prediction and analysis of Atrial Fibrillation (AF) and Ventricular Fibrillation (VF). Long-term monitoring of diseases such as AF and VF occurrences is very important, as these will lead to occurrence of ischemic stroke, cardiac arrest and complete heart failure. The AF and VF signal classification accuracy are much higher when processed on a Graphics Processor Unit (GPU) than Central Processing Unit (CPU) or traditional Holter machines. The classifier COMMA-Z filter is applied to the highly-sensitive industry certified Bio PPG sensor placed at the earlobe and computed on GPU.

Clinical Anatomical Characteristics of Patients with Rhino-Orbit-Cerebral Mucormycosis.

Background. Postponed coronavirus infection (COVID-19), accompanied by an immunosuppressive state and associated with the risk of secondary diseases such as mucormycosis. Diabetes mellitus is an independent risk factor for both severe COVID-19 and mucormycosis. Aims - our aim was to experience the diagnosis and treatment of rhino-orbitocerebral mucormycosis in post-COVID-19 patients. Materials. A single-center, observational, non-randomized, cohort comparative study was conducted. We assessed the clinical features, risk factors, diagnosis and outcomes of mucormycosis among recovered COVID-19 patients with hospitalisation in the otorhinolaryngology department of the Samara State Medical University Clinics, Samara, from September-December 2021. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Materials for microbiological and histopathological examination were taken from all examined patients intraoperatively. Results. The experience of diagnosing and treating rhinoorbitocerebral mucormycosis in patients after a new coronavirus infection was analyzed, the influence of the complex use of radiation diagnostic methods, histopathological and microbiological methods on the development and effectiveness of mucormycosis treatment was determined. Conclusions. The effectiveness of disease management directly depends on the early initiation of etiotropic treatment, while the role of complex radiological diagnostics, histopathological and microbiological methods is important for early confirmation of the fungal etiology of the disease.Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.

Utility of itraconazole and terbinafine in mucormycosis: a proof-of-concept analysis.

An epidemic of mucormycosis followed the second wave of COVID 19 in the state of Uttar Pradesh, India in May 2021. This epidemic, however, had additional challenges to offer in the form of acute shortage of all forms of amphotericin B, posaconazole and isavuconazole. It was, therefore, planned to assess the trends in minimum inhibitory concentration (MIC) of antifungal agents, viz itraconazole and terbinafine, and provide a template for personalized therapy to see whether the results could be translated clinically. This is an observational, single-center study. Samples comprising nasal swab, nasal and paranasal sinus tissue, brain tissue, brain abscess and orbital content, derived from 322 patients from northern India with mucormycosis, of whom 215 were male and 107 were female, were used for analysis. Cultures were identified both by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and conventional methods of identification. Antifungal susceptibility was done for amphotericin B, posaconazole, isavuconazole, itraconazole and terbinafine as per Clinical Laboratory Standard Institute M38-A2. The outcome was identification of the species of mucormycosis and susceptibility to itraconazole and terbinafine besides other primary antifungal agents. Patients or the public were not involved in the design, or conduct, or reporting or in the dissemination plans of our research. Of 322 patients, 203 were culture-positive, of whom 173 were positive by both MALDI-TOF and conventional methods of identification. Final antifungal susceptibility testing was available for 150 patients. The most common Mucorales found to cause this epidemic was Rhizopus oryzae, followed by R. microsporus Amphotericin B, posaconazole and isavuconazole had low MIC values in 98.8% of all Mucorales identified. The MIC of itraconazole was species-dependent. 97.7% of Roryzae had MIC ≤2 µg/mL. However, only 36.5% of Rmicrosporus had MIC ≤2 µg/mL. For terbinafine, 85.2% of R. microsporus had MIC ≤2 µg/mL. We conclude that identification at the species level is required as antifungal susceptibilities seem to be species-dependent. Assessment of the efficacy of itraconazole and terbinafine warrants further studies with clinical assessment and therapeutic drug monitoring as they seem to be potential candidates especially when the primary agents are not available.

Post COVID Mucormycosis-A Narrative Review

Mucormycosis is an Acute Invasive Fungal Rhinosinusitis (AIFR). Omnipresent fungi and their interaction with humans are both boon and a bane. Fungal rhinosinusitis is now becoming an alarming situation in today's world, especially in India. It can be classified further into invasive or non invasive and acute or chronic. Categorisation helps us with its diagnosis and management. The invasion of the hyphae portrays mucormycosis into sinus tissue within less than four weeks. It comes with various predisposing factors such as underlying systemic disease, drug therapy, transplantation, and local lesion. Clinical manifestations such as headache, sinonasal congestion, black lesions on the nasal bridge, and facial inflammation associated with pain are prevalent in immunocompromised patients. Crucial steps such as early identification, definite treatment with a multidisciplinary integrated approach of various departments such as ENT, medicine, and radiology should be made. Intraorbital and intracranial complications can be prevented by treating disease process in the early stage.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.

Rhino-orbital mucormycosis in COVID-19 patients—a new threat?

BackgroundCoronavirus disease 2019 (COVID-19) is known to be associated with a myriad of viral, fungal, and bacterial co-infections. Rhino-orbital mucormycosis is a rare angio-invasive fungal infection which has shown a rising trend in the setting of COVID-19.Case presentationWe describe the imaging findings in 3 cases of rhino-orbital mucormycosis in patients with history of COVID-19. All cases had varying involvement of paranasal sinuses extending into the orbital compartment while case 3 had intracranial extension of infection.ConclusionsRhino-orbital mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.

RADIOLOGY OF RHINOORBITOCEREBRAL MYCORMYCOSIS IN PATIENTS AFTER COVID-19.

Purpose. The analysis of CT and MR patterns of rhinoorbitocerebral mucormycosis (ROCM) among patients with type 2 diabetes (T2D) after COVID-19. Materials and methods. The study included 11 patients with confirmed COVID-19 and invasive ROCM in the long-term period. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Results. We report several CT and MR patterns for a series of patients: involvement of paranasal sinuses, orbits, optic nerves, large arteries;intracranial spread;involvement bones of cranial base. The features of differential diagnosis and recommendations for standard protocols are presented. Conclusion. CT of paranasal sinuses is the method of choice for suspected fungal infections. MRI is recommended if there is a suspicion of orbital, vascular, and intracranial complications or cavernous sinus extension. The combination of both methods makes it possible to showed soft tissue invasion and bony destruction to choose optimal medical tactics ROCM.Copyright © 2022 Russian Electronic Journal of Radiology. All rights reserved.

COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report

BackgroundThere has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM.Case presentationRhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed.ConclusionUncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.

Observational study of imaging findings in COVID -19 related rhino-orbito-cerebral mucormycosis - a tertiary care center study

Background: There has been a tremendous increase in number of cases of rhino-orbitocerebral involvement with mucor in the COVID era, as reported from India. It is well established that management of ROCM involves early clinical and radiological diagnosis, reversal of underlying risk factors, prompt antifungal therapy and surgical debridement when indicated. Materials &Methods: Multiplanar MR imaging and CT scan were performed for brain, orbit and paranasal sinuses. All the cases were assessed for involvement of the paranasal sinuses, nasal cavities, orbits and brain. Results: 25 cases with ROCM were identified over 8 months. The mean age of the cases was 56.1 years. 18 of the 25 cases had a positive RT-PCR test result at the time of diagnosis with ROCM. 20 cases had poorly controlled diabetes mellitus, 2 had a hematological malignancy, 2 had chronic kidney disease and 1 had ischemic heart disease. There was involvement of the paranasal sinuses, nasal cavities, orbits and brain inclusing necrosis in most of the cases. The number of cases identified during the interval is much higher than the numbers presenting in the prior 2 years during equivalent intervals than those reported in the literature in different settings in the pre-pandemic era. Conclusions: Rhino-orbito mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.

Evaluation of incidence and prognosis of COVID-19 in patients with Nasal Polyps

Objective: Coronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Type 2 immune response accompanied by type 2 cytokines such as IL-4, IL-5, IL-13, and eosinophilic inflammation, may have a potential protective effect against COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). In the study, it was aimed to investigation the prevalence and prognosis of COVID-19 in chronic rhinosinusitis patients with nasal polyps (CRS + P). Materials and Methods: Patients between the ages of 15-65 operated for CRS + P and were compared with the control group in terms of incidence and disease severity. Results: Covid RT-PCR test was positive in 5.04% of CRS + P patients. This rate was 8.96% in the control group, and the difference between both groups was statistically significant. When the two groups were compared in terms of disease severity, no significant difference was found. Conclusions: The incidence of COVID-19 was lower in patients with CRS + P. However, further prospective studies are needed to research the relationship between nasal polyp and COVID-19.

COVID-19-related orbital abscesses: a case report

Orbital cellulitis is a condition with a high risk of morbidity, including visual loss. It commonly originates from the paranasal sinuses. We present a case of multifocal intraorbital abscesses secondary to viral sinusitis in an adolescent with SARS-CoV-2 infection. This patient presented with classic symptoms of orbital cellulitis, but did not display classical symptoms of COVID-19. The patient initially underwent endoscopic drainage, followed by a combined approach which yielded no pus. He recovered without complication. This is the second report of its type showing a causative link between SARS-CoV-2 and orbital cellulitis.

Sinus, middle-ear and mastoid radiological findings of severe acute respiratory syndrome coronavirus-2.

OBJECTIVE: To assess the incidence of radiological inflammation within the paranasal sinuses, middle ear and mastoid in patients with confirmed severe acute respiratory syndrome coronavirus-2. METHODS: A retrospective cohort study was conducted to examine consecutive adults (aged over 18 years) with coronavirus disease 2019 (confirmed on polymerase chain reaction within 7 days of imaging) who underwent computed tomography of the head between 1 March 2020 and 24 June 2020. Lund-Mackay and mastoid and middle-ear opacification scores were used to categorise the extent of sinus and mastoid opacification on axial and coronal computed tomography images. RESULTS: Of 147 patients originally identified, only 83 met the inclusion criteria. Sinus opacification was present in 51.8 per cent of patients (n = 43), and middle-ear or mastoid opacification was observed in 24.1 per cent (n = 20). There was no statistically significant difference in sinus or middle-ear and mastoid opacification between patients after stratification based on 30-day all-cause mortality. CONCLUSION: Radiological computed tomography findings suggest mild mucosal disease within the sinuses, middle ear and mastoid. There was no statistical correlation between such opacification and 30-day mortality.

Histopathological Study of Mucormycosis in Post COVID-19 Patients and Factors Affecting it in a Tertiary Care Hospital.

Introduction. COVID-19 is an infection caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is an opportunistic fungal infection occurring in post COVID-19 patients. Objectives. To study the role of histopathology in mucormycosis and the predisposing factors associated in development of mucormycosis in post COVID-19 patients. Materials and methods. A prospective observational study was conducted in our hospital in the pathology department over a period of 3 months on 200 patients with mucormycosis who were infected with SARS-CoV-2 virus. Results. Out of the 200 patients with mucormycosis studied in post COVID-19 patients, age ranged from 21-80 years, of which 132 were men and 68 were women. Sites involved by mucormycosis were sinuses, orbit, cranium, and cutaneous. Ethmoid sinus was most involved, followed by maxillary sinus. Diabetes was present in 162 patients and hypertension in 92 patients. On histopathological examination, fungal load was severe in 49 patients, angioinvasion was present in 48 patients, perineural invasion was present in 32 patients, and necrosis was present in 121 patients. The number of patients discharged after surgery was 169, whereas 31 died. Conclusion. Histopathological features of mucormycosis like angioinvasion, perineural invasion, severe fungal load, and large areas of necrosis were directly proportional to the mortality rate. Thus, histopathologists can help in assessing prognosis at the time of tissue diagnosis, so that clinicians can optimize treatment accordingly. Diabetes and history of corticosteroid intake for treatment of COVID-19 were the two commonest predisposing factors for development of mucormycosis.

A Brief Review on Covid-19 associated Mucormycosis

Risk factors include uncontrolled diabetes mellitus, especially ketoacidosis, steroid use, age, neutropenia Mucormycosis diagnosis involves a careful examination of clinical manifestations, magnetic resonance imaging modalities, early use of computed tomography (CT). No Types Route of transmission 1 Rhinocerebral (sinus and brain) Mucormycosis Inhalation of spores into the of spores into the paranasal sinuses and the invasion of blood vessels in the tissue 2 Pulmonary (lung) Mucormycosis Inhalation of infectious material 3 Gastrointestinal Mucormycosis The ingestion of contaminated food/ herbal medicine 4 Cutaneous (skin) Mucormycosis Skin infection by direct inoculation and in secondary form, by dissemination from other locations. 5 Disseminated Mucormycosis Blood stream Etiopathogenesis: The mucous membrane penetrates deep tissues, swallowing or inhaling spores and injecting them into the skin. Risk factors include uncontrolled diabetes mellitus, especially ketoacidosis, steroid use, age, neutropenia;Voriconazole, especially for the prevention of blood cancer, AIDS, renal failure, organ or stem cell transplantation, iron overload, skin trauma, broad-spectrum antibiotics, intravenous drug use, aspergillosis and malnutrition7,11 Mucormycosis can also occur in patients without overt immunodeficiency. According to statistics

Study on covid-19 patients and the attacking fungus during post covid

Sign And Symptoms of Mucormycosis:3,4,11 * The sign to watch out for are a stuffy nose, Bloody, blackish or brown discharge from the nose, blackish discolouration of the skin, swelling or numbness around the cheek, one side facial pain, thoothache or jaw pain droping of eyelids or eyelid swelling, double vision, redness of eyes and sudden decrease vision * Mucormycosis is present itself as either a respiratory or skin infection * Mucormycosis can develop within any part of your body * If may initially occure at the site of skin trauma but it can quickly spread to another area * Black fungus symptoms mainly show some symptoms including running nose * You may feel swelling and pain your eyes * black fungal infection covid, eyelid loss and blurred vision * Darkspot can also be seen around the nose of the infected patient * Sign and symptoms fever * Headache * Nasal congestion * Sinus pain * Visual problem * Blister * Ulcer * Facial pain * Redness * Dark scabbing in the nose by eyes * Bloody and dark vomits * Swelling * Blocked skin tissue * Shortness of breath * Symptoms of sinus and brain (rhinocerebral) mucormycosis * One sided facial swelling * Headache * Nasal or sinus congestion * Blank lession on nasal Bridge or upper inside of mouth quickly * Symptoms of Lung (pulmonary) mucormycosis * Fever * Cough * Check pain * Shortness of breath skin (cutaneous) mucormycosis blister and ulcer excessive * Redness * Warmth * Swelling around wound Symptoms of (gastrointestinal) mucormycosis * Abdominal pain * nausea and vomiting * gastrointestinal bleeding Mucormycosis causes:5,6,12 Several different types of fungi can cause mucormycosis. [...]for people who have weakened immune systems, breathing in mucormycete spores can cause an infection in the sinuses which can spread to other parts of the body. Information regarding the current approach to treatment is based on single-institution, retrospective studies including a limited number of patients with significant variability in their presentation and risk factors, registries with methodological flaws, and "expert opinions. Promote Antifungal Therapy: In antifungal therapy the primarily stge is dispence of antifungal medicines to the patient Such as;Amphotericine B (Trough an IV) Posaconazole (through IV and salline) Isavucanazole (through IV and salline) Amphotericine B Molecular Formula of Amphotericine В: * Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. * Amphotericin B was isolated from Streptomyces nodosus in 1955 at the Squibb For Medical Research Institute from cultures isolated from the streptomycete obtained from the river bed of Orinoco in that region of Venezuela Posaconazole: Molecular formula of Posaconazole: Posaconazole is a novel lipophilic antifungal triazole that inhibits cytochrome P450-dependent 14alpha demethylase in the biosynthetic pathway of ergosterol.