Acute invasive fungal rhinocerebral sinusitis associated with COVID-19 pneumonia

The following is “Imaging spectrum, correlates, and outcomes of acute invasive fungal rhino-ophthalmosinusitis in patients with COVID-19 pneumonia” Published in the June 2023 issue Family Medicine and Primary Care Patel et al.

It has been hypothesized that coronavirus disease 2019 (COVID-19) may exacerbate mucormycosis infections due to its immunosuppressive pathogenesis. Early identification of diseases with high mortality is critical for optimal treatment and improved outcomes. Approximately 63 patients with clinical and microbiological evidence of rhino-ophthalmocerebral mucormycosis and a history of COVID-19 infection participated in a retrospective study. Researchers retrieved and analyzed clinical, demographic, and imaging data.

Descriptive statistics (mean (SD) and frequency (%)) were used to describe significant characteristics throughout the review cycle. All 63 patients were treated with injectable and oral corticosteroids. Diabetes was the most common among the 54 patients with associated comorbidities. Imaging showed involvement of the paranasal sinuses, paranasal sinuses, per sinus, maxillary alveolar arch, and hard palate in 62 (98.41%), 33 (52.38%), 5 (7.94%), and 5 (7.94%) patients, respectively. Orbital involvement was present in 24 (38.10%) patients. The skull base was involved in 11 patients (17.46%), and the lesions spread to the intracranium in 11 patients (17.46%).

Sixteen patients received mechanical ventilation and three died. The mean (SD) intensive care unit (ICU) length of stay was 13.2 days (6.8) for the 5 patients who died and 6.4 days (4.6) for the 30 surviving patients (P = 0.003). Cross-sectional imaging not only determines the extent of disease spread, but also plays a critical role in providing surgeons with a roadmap for treatment and predicting prognosis for patients with invasive fungal infections.


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