ABSTRACT
Objective: Acute Invasive Fungal Rhinosinusitis is a rare condition which recently has gained attention due to its increased occurrence in the post COVID-19 patients past the second wave. The current study retrospectively evaluates the occurrence of Acute Invasive Fungal Rhinosinusitis (Mucormycosis) in post COVID-19 (Corona Virus Disease-19) patients. Methods: A descriptive study included patients diagnosed with Acute Invasive Fungal Rhinosinusitis (Mucormycosis) after recent COVID-19 infection. 110 patients were evaluated retrospectively with histopathological confirmation of Mucormycosis. Surgical treatment was restricted to patients who tested Real Time Polymerase Chain Reaction (RT PCR) negative for COVID-19 except for three patients who were tested positive. Antifungal agents were given to patients following surgery. Results: A total of 110 patients with a mean age of 48.42 years were included. The most common risk factor was diabetes mellitus (88.2%). Sino-nasal, orbital, palatal and intracranial involvement were 57.9%, 48.5%, 12.7% and 5.6% respectively. Histopathological confirmation revealed mucormycosis. The most common reported symptoms were periorbital oedema (20.5%), headache (20.3%), gingival swelling (18.5%) facial pain (18.4%) and facial swelling (18.2%). All the patients were treated with surgical debridement and antifungal medications. The overall survival rate was 95.32%. Conclusion: Acute Invasive Fungal Rhinosinusitis is a life-threatening opportunistic infection. Patients with moderate to severe COVID-19 infection are more susceptible to it. Uncontrolled diabetes mellitus and intake of corticosteroids increase the risk of developing Acute Invasive Fungal Rhinosinusitis. Early diagnosis and timely management can improve survival rates of the patients.
ABSTRACT
The storm of COVID-19-associated mucormycosis (CAM) has not yet settled, and it has proven itself a disfiguring and potentially life-threatening disease, complicating the course of COVID-19 infection. Mucormycosis is a rare but devastating fungal infection caused by filamentous fungi of the family Mucoraceae. We report a rare case of a 37-year-old diabetic male with bilateral rhino-orbital-cerebral mucormycosis (ROCM) where it leads to bilateral central retinal artery occlusion (CRAO) as manifestation of the disease. Bilateral CRAO secondary to ROCM is extremely rare. A strong suspicion of CAM in uncontrolled diabetics can result in early diagnosis and management.