Comparison of MRI Findings in Diabetic and Nondiabetic Patients with Rhino-Orbito-Cerebral Mucormycosis

Abstract

Objective Rhino-orbito-cerebral mucormycosis (ROCM) has emerged as a key concern during the period of coronavirus disease 2019 (COVID-19) pandemic. Diabetes mellitus is a known risk factor for invasive fungal infection. The aim of this article was to study and compare the radiological features of COVID-19-associated ROCM between diabetic and nondiabetic patients using magnetic resonance imaging. Materials and Methods A retrospective observational study comprising 78 diabetics and 40 nondiabetics who developed ROCM after COVID-19 was conducted. The imaging data of both groups were analyzed, findings tabulated and compared using statistical methods. Results Maxillary and ethmoid sinuses were commonly involved in both groups. Periantral fat and orbits were the most common sites of disease extension. The spread of infection to periantral soft tissue was significantly higher in diabetics (p = 0.049). Diabetics were more likely to have bone, orbit, and brain involvement than nondiabetics, although the difference was not statistically significant. Diabetic patients were the only ones to experience complications such as fungal abscess and cavernous sinus and internal carotid artery involvement. However, a considerable number of nondiabetic patients (22.5%) also had an intracranial extension of disease. Conclusion The radiological appearances and common sites of invasion in ROCM are similar in diabetic and nondiabetic patients. The extensive spread of infection to extra-sinus regions can occur in nondiabetic patients with COVID-19 but is less frequent compared with diabetics.

A Retrospective Study of Imaging of Invasive Rhino-Orbital-Cerebral Mucormycosis in the COVID-19 Pandemic in a Tertiary Care Center

“…According to progression and extent of involvement, we categorized the disease radiologically as Stage 1 rhinosinusitis with no extrasinus extension, Stage 2 rhino-orbital, and Stage 3 ROCM. Similar categorization is done clinically by Firke and Deshmukh [ 15 , 16 ].…”

Annals of National Academy of Medical Sciences (2022) …An Appraisal

“…Among important review articles, second issue published “Best practice guidelines for breast imaging” part 1 and 2 authored by Chakrabarthi et al for Breast Imaging Society. 1 2 Another article is on Patient Safety, Clinical Microbiology, and Collaborative Healthcare by Chugh et al 3 We published two articles on mucormycosis and coronavirus disease 2019 (COVID-19) infection 4 5 and one each on COVID-19 vaccination and use of telemedicine in Covid-19 time. 6 7…”