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AJR Am J Roentgenol ; 217(6): 1431-1432, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526736


An increasing incidence of rhinoorbitocerebral mucormycosis (ROCM) among patients with COVID-19 has recently been reported in India. We report the imaging findings for 25 patients with COVID-19 and invasive ROCM at a single hospital in India. Findings included sinus wall erosions (n = 20), air within bony sinus structures (n = 11), and focal mucosal nonenhancement (n = 8). Orbital, vascular, and intracranial complications were also observed. Radiologists should recognize the increasing incidence of ROCM among patients with COVID-19 to facilitate early diagnosis.

COVID-19/complications , Central Nervous System Fungal Infections/diagnostic imaging , Mucormycosis/diagnostic imaging , Orbital Diseases/diagnostic imaging , Paranasal Sinus Diseases/diagnostic imaging , Adult , Aged , Central Nervous System Fungal Infections/epidemiology , Central Nervous System Fungal Infections/microbiology , Female , Humans , Incidence , India/epidemiology , Magnetic Resonance Imaging/methods , Male , Middle Aged , Mucormycosis/epidemiology , Optic Nerve Diseases/diagnostic imaging , Optic Nerve Diseases/microbiology , Orbital Diseases/epidemiology , Orbital Diseases/microbiology , Paranasal Sinus Diseases/epidemiology , Paranasal Sinus Diseases/microbiology , Paranasal Sinuses/diagnostic imaging , Paranasal Sinuses/microbiology , Retrospective Studies , Tomography, X-Ray Computed/methods
Diabetes Metab Syndr ; 15(5): 102267, 2021.
Article in English | MEDLINE | ID: covidwho-1377695


AIMS: 1: Describe the epidemiology and determine risk factors for COVID-19 associated mucormycosis. 2: Elaborate the clinical spectrum of Rhino-Orbital-Cerebral Mucormycosis (ROCM), pattern of neuroaxis involvement and it's radiological correlates. METHODS: Observational study. Consecutive, confirmed cases of mucormycosis (N = 55) were included. A case of mucormycosis was defined as one who had clinical and radiological features consistent with mucormycosis along with demonstration of the fungus in tissue via KOH mount/culture/histopathological examination (HPE). Data pertaining to epidemiology, risk factors, clinico-radiological features were analysed using percentage of total cases. RESULTS: Middle aged, diabetic males with recent COVID-19 infection were most affected. New onset upper jaw toothache was a striking observation in several cases. Among neurological manifestations headache, proptosis, vision loss, extraocular movement restriction; cavernous sinus, meningeal and parenchymal involvement were common. Stroke in ROCM followed a definitive pattern with watershed infarction. CONCLUSIONS: New onset upper jaw toothache and loosening of teeth should prompt an immediate search for mucormycosis in backdrop of diabetic patients with recent COVID-19 disease, aiding earlier diagnosis and treatment initiation. Neuroaxis involvement was characterized by a multitude of features pertaining to involvement of optic nerve, extraocular muscles, meninges, brain parenchyma and internal carotid artery.

COVID-19/complications , Mucormycosis/epidemiology , Mucormycosis/etiology , Adult , COVID-19/epidemiology , Central Nervous System Fungal Infections/epidemiology , Central Nervous System Fungal Infections/etiology , Eye Infections, Fungal/epidemiology , Eye Infections, Fungal/etiology , Female , Humans , India/epidemiology , Male , Middle Aged , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , Nervous System Diseases/microbiology , Orbit/microbiology , Orbital Diseases/epidemiology , Orbital Diseases/microbiology , Prevalence , Rhinitis/epidemiology , Rhinitis/etiology , Rhinitis/microbiology , Risk Factors , SARS-CoV-2/physiology , Socioeconomic Factors