[Late diagnosis of rhinocerebral mucormycosis in patients with COVID-19 (case studies)]. / Pozdnyaya diagnostika rinotserebral'nogo mukormikoza u bol'nykh COVID-19 (klinicheskie nablyudeniya).

From the beginning of the COVID-19 pandemic, the incidence of secondary infections (both bacterial and fungal) has increased due to immune suppression associated with the use of corticosteroids or broad-spectrum antibiotics as a part of COVID-19 treatment protocol, which may exacerbate a pre-existing fungal disease or cause a new infection. Ophthalmologists are often involved in taking medical and surgical decisions in these complex cases. In this regard, a strong clinical suspicion should be applied to possible secondary fungal infections in COVID-19. Their early diagnosis and treatment may reduce mortality due to COVID-19 associated rhinocerebral mucormycosis (ROCM). This article describes two clinical cases of late detection of ROCM with two different scenarios, and compare the features of these cases with the literature data.

[Factors influencing the results of osteodensitometry in searching for systemic osteoporosis].

Osteodensitometry (ODM) performed in 485 persons aged 15 to 83 years, referred for ODM due to their having various causes, has demonstrated a significant reduction in bone density in both males and females above 50 years of age. The density of each vertebra individually in patients without cancer and inflammation of the spine is different, even in youth. The difference between the density of the bodies of individual vertebra increases with age. The vertebral density difference is particularly great in osteoplastic metastases. All the processes accompanied by osteogenesis or calcification both within and around the bone increase ODM values excessively. ODM values are decreased by not only osteoporosis, but also by any other bone destruction (tumorous, inflammatory, non-inflammatory), the increased area of a portion under study due to neoplasia of an immature bone, and by intestinal gas at the level of lumbar vertebrae. The older the patient is, the more factors distorting the results of ODM are. The role of each factor is reflected in the present communication. Not only the densitometric, but also X-ray patterns of the area under study should be taken into account to give an objective and final assessment of a specific situation.