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1.
AJR Am J Roentgenol ; 217(6): 1431-1432, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526736

ABSTRACT

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.


Subject(s)
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
2.
AJR Am J Roentgenol ; 217(6): 1431-1432, 2021 12.
Article in English | MEDLINE | ID: covidwho-1456222

ABSTRACT

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.


Subject(s)
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
3.
Pan Afr Med J ; 39: 183, 2021.
Article in English | MEDLINE | ID: covidwho-1395298

ABSTRACT

Mucormycosis is relatively uncommon, fulminant, progressive, life threatening fungal disease which is most often seen in debilitating patients with immunocompromised condition. Mucormycosis cases are seen in patients with the use of systemic steroids in the treatment of severely affected COVID-19 cases and also in the patients with uncontrolled diabetes which causes immunosuppression are being reported with mucormycosis. The main symptoms of this disease include pain on the temporal and the orbital region of the affected side which could be throbbing or lancinating type, mobility of the teeth, jaw pain and often swelling is present which could be extraoral and intraoral both or sometimes only intraorally. The diagnostic approach in such cases is done with the help of clinical diagnosis, histopathology and with advanced imaging like cone beam computed tomography, magnetic resonance imaging and computed tomography. We here used cone beam computed tomography imaging that revealed haziness in the sinuses and breach in cortical bone of the affected area which confirmed the diagnosis of mucormycosis. Early treatment planning like administration of antifungal drugs and surgical debridement will be life saving in such a deadly disease.


Subject(s)
COVID-19/complications , Cone-Beam Computed Tomography/methods , Mucormycosis/diagnostic imaging , Antifungal Agents/administration & dosage , Cortical Bone/diagnostic imaging , Debridement , Humans , Male , Middle Aged , Mucormycosis/therapy , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinus Diseases/microbiology , Paranasal Sinus Diseases/therapy
4.
J Neurovirol ; 27(4): 644-649, 2021 08.
Article in English | MEDLINE | ID: covidwho-1338289

ABSTRACT

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.


Subject(s)
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
5.
Clin Radiol ; 76(10): 784.e27-784.e33, 2021 10.
Article in English | MEDLINE | ID: covidwho-1336359

ABSTRACT

AIM: To analyse combined computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of invasive rhino-orbital mucormycosis (IROM) in post-COVID-19 infection patients for accurate diagnosis and delineation of the extent of involvement. MATERIALS AND METHODS: A retrospective analysis was undertaken of 50 patients who developed IROM post-COVID-19 infection who underwent combined CT/MRI evaluation. RESULTS: The age range of the 50 affected patients was 23-73 years. Out of these, 41 were diabetic. CT/MRI showed predominant involvement of the maxillary (n=26) and ethmoid (n=19) sinuses. Extension of disease to the orbit (n=35), cavernous sinus (n=18), hard palate (n=15), skull base (n=8), and intracranial involvement (n=3) was seen. Perineural spread of the disease was analysed along all divisions of the trigeminal nerve and its branches. MRI showed T2-hypointense soft-tissue thickening with heterogeneous contrast enhancement with corresponding hyperdensities on CT diagnosing the presence of fungal elements. CONCLUSION: Clinicians should be aware of the possibility of IROM post-COVID-19 infection. Conjunctive use of CT, which depicts bone destruction and other reactive bony changes along with MRI, which reveals characteristic findings of soft-tissue thickening of the involved sinuses with extension of disease to the orbits, cavernous sinus, dura, hard palate, skull base, and intracranial structures. Accurate diagnosis and early recognition of the disease and its extension with appropriate use of these techniques helps to initiate appropriate and timely treatment, which is vital to prevent a fatal outcome.


Subject(s)
COVID-19/complications , Mucormycosis/diagnostic imaging , Multimodal Imaging , Orbital Diseases/diagnostic imaging , Paranasal Sinus Diseases/diagnostic imaging , Adult , Aged , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Orbital Diseases/microbiology , Paranasal Sinus Diseases/microbiology , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
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