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Background: Acute invasive fungal rhinosinusitis (AIFR) is a potentially fatal infection that usually complicates immunosuppressive status like uncontrolled or newly discovered diabetes mellitus, during the coronavirus disease (COVID19) pandemic, worsening of underlying diabetes and newly discovered cases have been observed. Aim: To highlight the impact of COVID-19 on emerging cases of AIFRS comparing this with AIFR before COVID-19 pandemic. Methods: This is a retrospective comparative study between AIFR patients presenting to Tanta University Hospital, Egypt between July and December 2020 with a recent proven COVID-19 infection and AIFR patients presenting to the same institution prior to the covid-19 pandemic between January 2017 and December 2019. Results: There was a dramatic increase in the rate of incidence of AIFR in patients with recent covid-19 infection in comparison with pre COVID-19 pandemic numbers. On the other hand, there was no statistical difference in the severity, extent of lesion or survival rate between the two groups. Conclusion:A bidirectional relationship between Covid-19 and diabetes mellitus was observed together with immune dysregulation playing a possible role in subsequent increase in the rate of incidence of AIFR making it more emerging and more challenging.

ObjectiveThis study aimed to record recent changes in the incidence and clinical and histopathological patterns of rhinoscleroma in the middle of Nile Delta in Egypt.MethodTwenty-eight patients with rhinoscleroma were included in this study. Patients who were attending the Department of Otolaryngology at Tanta University Hospitals from January 2014 to January 2019 were included. Cases were diagnosed by clinical, bacteriological and histopathological data. Nasal biopsies were taken for histopathological and electron microscopy studies. All patients received a twelve-week course of 500 mg ciprofloxacin tablets twice daily.ResultsThe rate of rhinoscleroma was shown to be decreasing compared with previous studies. In this study, the disease mainly affected the nose without involvement of the palate, lips, Eustachian tube or bronchi. Histopathological and electron microscopy analyses showed that most cases were in the atrophic and fibrotic stages rather than the granulomatous stage of disease.ConclusionThe incidence of rhinoscleroma in Egypt is decreasing and its clinical and histopathological patterns are changing to less advanced forms. This may be explained by the improvement in socioeconomic conditions and methods of treatment.

Scleroma is a chronic-specific granulomatous disease caused by gram-negative Klebsiella rhinoscleromatis bacilli. It usually affects the upper respiratory tract from the nose to the trachea. The nose tends to be affected in almost all cases, hence the term rhinoscleroma. It is prevalent in rural areas where overcrowding, poor hygiene and deficient nutrition may promote the disease. The disease is en-

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