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J Neurovirol ; 27(4): 644-649, 2021 08.
Article in English | MEDLINE | ID: covidwho-1338289


Among the ever-increasing literature of the coronavirus disease 2019 (COVID-19), there have been reports on several complications in association with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), such as secondary bacterial and fungal infections. We report a 61-year-old woman with a past history of diabetes mellitus who presented to our hospital suffering from COVID-19 infection. During the course of her hospitalization, the patient developed chemosis and proptosis in both eyes, ultimately leading to a diagnosis of invasive rhino-orbital-cerebral mucormycosis and cerebrovascular thrombosis. This study strengthens the possible association between the occurrence of COVID-19 and invasive mucormycosis infection, providing new impetus for further investigations to substantiate this correlation.

COVID-19/complications , Mucormycosis/complications , Brain Infarction/etiology , Diabetes Mellitus , Fatal Outcome , Female , Humans , Hypertension , Intracranial Thrombosis/etiology , Middle Aged , Paranasal Sinus Diseases/complications , Paranasal Sinus Diseases/microbiology
BMJ Case Rep ; 14(4)2021 Apr 27.
Article in English | MEDLINE | ID: covidwho-1206018


A middle-aged woman with diabetes presented with left-sided facial pain, complete ptosis and fever of short duration. On presentation, she had hyperglycaemia without ketosis. There was total ophthalmoplegia of the left eye with a visual acuity of 6/36. She incidentally tested positive for COVID-19. CT paranasal sinus and MRI brain revealed left-sided pansinusitis with acute infarct in the left parieto-occipital region without angioinvasion. An emergency functional endoscopic sinus procedure was done, which confirmed mucormycosis on histopathological examination. After 1 week of conventional amphotericin B and antibiotics, repeat CT brain showed improvement in mucosal thickening and sinusitis. This case is a rare presentation of mucormycosis associated with rapid progression to orbital apex syndrome with brain infarction in a patient with non-ketotic diabetes and COVID-19. Early diagnosis and treatment are essential to prevent further end-organ damage. It is also interesting that there was no angioinvasion and transient periarterial inflammation was attributed to brain infarction.

Blepharoptosis/complications , COVID-19/complications , Diabetes Complications , Mucormycosis/diagnosis , Ophthalmoplegia/complications , Orbital Diseases/complications , Paranasal Sinus Diseases/complications , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Brain/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Mucormycosis/drug therapy , Orbital Diseases/diagnostic imaging , Orbital Diseases/etiology , Paranasal Sinus Diseases/diagnostic imaging , SARS-CoV-2 , Tomography, X-Ray Computed , Treatment Outcome