Spectrum of invasive Rhino-orbito-cerebral mucormycosis in patients with COVID 19 infection: A new challenge

Abstract

Introduction: COVID-19 is known to be associated with superimposed viral, fungal, and bacterial co-infections. However Sinonasal mucormycosis is an uncommon entity but there is significant rise in the incidence in patients with COVID-19 pneumonia mainly due to prolonged hospital stay and immunocompromised status of the patients. These infections are highly invasive nature and tend to be locally aggressive in nature involving orbits and/or intracranial structures.Case Series: We describe the imaging findings in 5 cases of rhino/sino-orbital mucormycosis in patients with history of COVID-19. All cases had varying involvement of paranasal sinuses extending into the orbital compartment and some demonstrating intracranial extension of infection.Conclusions: Rhino/Sino-orbital mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct imaging diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.