Rhino-orbito-cerebral mucormycosis: Magnetic resonance imaging

Lone, Parveen Akhter; Wani, Nisar Ahmad; Jehangir, Majid

doi:10.4103/0971-7749.159700

Cited by 27 publications

(15 citation statements)

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“…Fungal hyphae involving nerves & vessel wall lead to extensive perineural & cavernous sinus invasion. 7,11 In our imaging study 18 cases showed non-enhancement of (avascular) half of medial & superior nasal turbinates with mucosal thickening.…”

Section: Discussionmentioning

confidence: 67%

“…3,5 Imaging findings on MRI with contrast gadolinium scan shows hyperdense foci within left ethmoid and sphenoid sinuses with orbital extension. 7 Microscopic examination shows respiratory epithelial lining with stroma showing fungal elements in the form of broad aseptate hyphae with wide angle branching, fungal granulomas, foreign-body giant cells dense mixed inflammatory infiltrate with predominant eosinophils and neutrophils admixed areas of necrotic tissue . Gomori's silver methenamine stain highlights black pigmented Broad aseptate hyphae.…”

Section: Introductionmentioning

confidence: 99%

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Invasive Mucormycosis in post covid patients at a Tertiary Health Care Centre

Pravalika¹,

Pavani²,

Vivekanand³

2021

TJIMA

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Rhino cerebral Mucormycosis is the current life-threatening infection commonly affecting immunocompromised patients espe-cially post COVID-19 within 6 weeks having poor glycemic control, Intravenous drug users, ICU patients, post chemotherapy, iron overload, persistent neutropenia and follow-up cases of hematological malignancies. It affects the nasal and paranasal sinuses by air-borne spores producing the infection. A prospective case series conducted at the department of pathology, KAMSRC between May 1st to September 30th 2021 with a study population of 27 cases. Variables included age, gender, history of covid, duration and development of symptoms, Clinical presentation, clinical diagnosis, co-morbidities, histopathological examination and microbiological correlation. The most prevalent isolated agent is Mucor (48.1%) followed by Rhizopus (18.5%), Aspergillus (11.1%) and mixed mucor with aspergillus (11.1%). Conclusion: Understanding the mechanism of host innate immunity and specific preventive strategies are important for favorable prognosis. Histopathological examination aids in early diagnosis of Mucormycosis

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Invasive Mucormycosis in post covid patients at a Tertiary Health Care Centre

Pravalika¹,

Pavani²,

Vivekanand³

2021

TJIMA

View full text Add to dashboard Cite

show abstract

“…Bulging of the lateral walls of the sinus, abnormal dural enhancement of the lateral wall, abnormal signal intensity of the sinus (iso-hypointensity on T1 and hyperintensity on T2), and presence of filling defects on post contrast scans (Fig. 1) indicate cavernous sinus thrombosis [8,9]. Paracavernous soft tissue extension can also be seen (Figs.…”

Section: Extension Into Cavernous Sinusmentioning

confidence: 99%

“…Intracerebral haematoma is a rare manifestation of ROCM, seen as a result of possible ruptured mycotic aneurysm which are most often seen in the anterior circulation [9,16] Leptomeningitis/pachymeningitis MR images demonstrate thick, often nodular, meningeal enhancement on post contrast T1-weighted and FLAIR images, due to thick gelatinous exudates containing inflammatory cells, fibrin, and haemorrhage leading to arachnoiditis which in turn can lead to secondary hydrocephalus (Fig. 12) [16].…”

Section: Haemorrhagementioning

confidence: 99%

Spectrum of intracranial complications of rhino-orbito-cerebral mucormycosis — resurgence in the era of COVID-19 pandemic: a pictorial essay

et al. 2021

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Rhino-orbito-cerebral mucormycosis (ROCM) has regained significance following its resurgence in the second wave of the COVID-19 pandemic in India. Rapid and progressive intracranial spread occurs either by direct extension across the neural foraminae, cribriform plate/ethmoid, walls of sinuses, or angioinvasion. Having known to have a high mortality rate, especially with intracranial extension of disease, it becomes imperative to familiarise oneself with its imaging features. MRI is the imaging modality of choice. This pictorial essay aims to depict and detail the various intracranial complications of mucormycosis and to serve as a broad checklist of structures and pathologies that must be looked for in a known or suspected case of ROCM.

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“…Infiltration of the cavernous sinus and orbital apex, with resulting facial cellulitis and vision loss, is a frequent complication with fatal consequences. Intracranial involvement can cause internal carotid artery (ICA) occlusion and ischemic infarctions [9].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Features of Rhino-Orbito-Cerebral Mucormycosis in Post-COVID-19 Patients: Radio-Pathological Correlation

et al. 2023

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There has been a notable increase in rhino-orbito-cerebral mucormycosis (ROCM) post-coronavirus disease 2019 (COVID-19), which is an invasive fungal infection with a fatal outcome. Magnetic resonance imaging (MRI) is a valuable tool for early diagnosis of ROCM and assists in the proper management of these cases. This study aimed to describe the characteristic MRI findings of ROCM in post-COVID-19 patients to help in the early diagnosis and management of these patients. This retrospective descriptive study was conducted at a single hospital and included 52 patients with COVID-19 and a histopathologically proven ROCM infection who were referred for an MRI of the paranasal sinuses (PNS) due to sino-orbital manifestations. Two radiologists reviewed all the MR images in consensus. The diagnosis was confirmed by histopathological examination. The maxillary sinus was the most commonly affected PNS (96.2%). In most patients (57.7%), multiple sinuses were involved with the black turbinate sign on postcontrast images. Extrasinus was evident in 43 patients with orbital involvement. The pterygopalatine fossa was involved in four patients. Three patients had cavernous sinus extension, two had pachymeningeal enhancement, and one had epidural collection. The alveolar margin was affected in two patients, and five patients had an extension to the cheek. The awareness of radiologists by the characteristic MRI features of ROCM in post-COVID-19 patients helps in early detection, early proper management, and prevention of morbid complications.

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Rhino-orbito-cerebral mucormycosis: Magnetic resonance imaging

Cited by 27 publications

References 0 publications

Invasive Mucormycosis in post covid patients at a Tertiary Health Care Centre

Invasive Mucormycosis in post covid patients at a Tertiary Health Care Centre

Spectrum of intracranial complications of rhino-orbito-cerebral mucormycosis — resurgence in the era of COVID-19 pandemic: a pictorial essay

Magnetic Resonance Imaging Features of Rhino-Orbito-Cerebral Mucormycosis in Post-COVID-19 Patients: Radio-Pathological Correlation

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