Epidemic in pandemic: Fungal sinusitis in COVID-19

Sasanka, KS. B S. Krishna; Arora, R; Nagarkar, NitinM; Thangaraju, Pugazhenthan; Mehta, Rupa; Satpute, SatishS; Chakravarty, Sharmistha; Keche, Archana; Aggarwal, Aakash; Sudha, T.

doi:10.4103/jfmpc.jfmpc_1352_21

Cited by 4 publications

(1 citation statement)

References 12 publications

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“… 40 Similarly, Arora et al reported that in their study regarding co-infection of COVID-19 and mucormycosis, all patients (n=24) presented with paranasal involvement, 7 with palatal involvement, 13 with intra-orbital and 3 with intracerebral involvement. 41 In a case presentation, complementary MRI and CT scan of left maxillary sinus revealed invasive fungal sinusitis limited to that area and did not show any associated complications with the orbit or brain. 42 …”

Section: Resultsmentioning

confidence: 80%

COVID-19-Associated Rhinocerebral Mucormycosis, an Incidental Finding or a Matter of Concern – Mixed-Method Systematic Review

Andreescu,

Moldovan,

Lespezeanu

et al. 2024

IDR

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With the advent of COVID-19, the number of patients diagnosed with mucormycosis has increased, especially in developing countries. The reason behind this increase is that COVID-19 causes hypoxia that promotes the growth of fungus. To identify the association between mucormycosis and COVID-19, in critically ill or immunocompromised COVID-19 patients. The literature included in the review was researched from October 1, 2021, to November 1, 2022, by using the Google Scholar database as the search engine. Of the 20 articles included, there were 4 case reports, 2 case series, 10 narrative reviews, and 4 quantitative studies. Mucormycetes growth is caused by several factors, including hyperglycemia owing to previously existing diabetes or excessive use of steroids, increased ferritin levels owing to the inflammatory cascade initiated by COVID-19, and immunosuppression caused by the use of steroids or other immunosuppressive therapy. Reduced white-cell count and activity in COVID-19 leads to increased germination of fungal spores hence developing a catastrophic picture of rhinocerebral mucormycosis. Considering that the hematological patient is frequently treated with cortisone, immunosuppressed due to the underlying condition, but also through the administered therapy, the association with a possible diabetes makes this patient susceptible to developing rhinocerebral mucormycosis during COVID-19 infection. Despite being severe, the association between mucormycosis and COVID-19 is specific and treatable. Development of mucormycosis in hematological patients suffering from severe COVID-19 disease is dangerous, yet not compulsory and can be prevented. Using a common steroid-dose protocol with hyperbaric oxygen and necessary preventive measure reveals the disease as a superadded infection. Hypoxia, poor glycemic control and overuse of steroids or immunosuppressive drugs cause it.

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Section: Resultsmentioning

confidence: 80%

COVID-19-Associated Rhinocerebral Mucormycosis, an Incidental Finding or a Matter of Concern – Mixed-Method Systematic Review

Andreescu,

Moldovan,

Lespezeanu

et al. 2024

IDR

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Trends in orbital cellulitis severity and management: 2016 through 2022

Gibbons,

Elsafy,

Campbell

et al. 2024

Orbit

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Radiological findings of mucormycosis rhinosinusitis among Indian COVID-19 patients during the pandemic second wave

Manuel

George

2023

Egypt J Otolaryngol

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Background Sinonasal mucormycosis is a quickly progressing and lethal fungal disease which showed an increased incidence in COVID-19 patients in the Indian population during the second wave of the pandemic. The objective of this study was to study the various sinus areas affected and the imaging findings of the disease. Methods The imaging records of patients with sinonasal mucormycosis during the second wave of the COVID-19 pandemic were reviewed and analysed for whom computed tomography (CT) and/or magnetic resonance imaging (MRI) images had been performed. Results Of the 65 patients, 6.1% had single sinus involvement, and 93.9% had multiple sinus involvement, and out of latter, 91.8% had bilateral sinuses affected by the disease process. A total of 49.2% patients with sinus involvement had erosions of the sinus walls. A total of 35.4% patients had only sinonasal mucormycosis, 38.5% patients had rhino-orbital mucormycosis, 4.6% patients had rhino-cerebral mucormycosis and 16.9% patients had rhino-orbitocerebral mucormycosis. The pterygopalatine fossa was affected in 26.2% patients. A total of 9.2% patients had cavernous sinus thrombosis. A total of 12% of the cases had infarction in the cerebral hemispheres. Conclusion In a setting of sinonasal mucormycosis, especially in the immuno-compromised and with those infected with COVID-19, cross-sectional imaging can assess the presence and extent of the disease and helps plan its medical and surgical management.

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Epidemic in pandemic: Fungal sinusitis in COVID-19

Cited by 4 publications

References 12 publications

COVID-19-Associated Rhinocerebral Mucormycosis, an Incidental Finding or a Matter of Concern – Mixed-Method Systematic Review

COVID-19-Associated Rhinocerebral Mucormycosis, an Incidental Finding or a Matter of Concern – Mixed-Method Systematic Review

Trends in orbital cellulitis severity and management: 2016 through 2022

Radiological findings of mucormycosis rhinosinusitis among Indian COVID-19 patients during the pandemic second wave

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