Rhinoorbital mucormycosis in patients with the post-COVID syndrome. Clinical and morphological features

Subject. Postcovid necrosis of the maxillofacial region is one of the severe consequences of a new coronavirus infection, the etiology and pathogenesis of which are not fully understood. A large number of researchers emphasize the leading role of molds in the development of this complication, which they characterize as COVID-19-associated rhino-orbito-cerebral mycosis. However, there is a point of view that the inflammatory process in post-covid necrosis can also be caused by other pathogens - saprophytic microflora. The aim of the study was to evaluate the results of microbiological examination in patients with Postcovid necrosis of the maxillofacial region and in the risk group for this complication. Methodology. The main study group consisted of 19 patients with signs of osteonecrosis of the bones of the facial skeleton and inflammatory lesions of the paranasal sinuses after suffering a coronavirus infection (Postcovid necrosis of the maxillofacial region). Control group (risk group) - 32 patients with severe COVID-19 without the above manifestations. A microbiological study was performed - a smear from the mucous membrane in the region of the middle nasal passage, smear microscopy, seeding on standard and elective (Saburo) media before treatment. Data were compared using Fisher's exact test for p<0.05. Results. In the main group there were 19 people - 10 men (52.63%), 9 women (47.37%), aged 54 to 73 years, in the control group - 18 (56.25%) men, 14 (43, 75%) women, 52 to 83 years old. In the main group, Streptococcus viridans, Klebsiella pneumonia and Mucor spp. were detected significantly more often (p<0.05), and Staphylococcus aureus was found in the risk group. Mycelium of mold fungi was found only in 3 patients of the main group, in the rest the absence of fungal invasion was confirmed cytologically and pathohistologically. Conclusions. The data obtained confirm the assumption that the inflammatory process in Postcovid necrosis of the maxillofacial region can be caused by various pathogens and is an opportunistic nosocomial infection. It is required to monitor patients at risk and timely treatment if they develop specific symptoms.

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Differences in the Microbiological Picture in Patients With Post-Covid Osteonecrosis of the Maxillofacial Region and the Risk Group for This Complication

Ivanyuta¹,

Christoforando

Spevak

et al. 2023

Actual Problems in Dentistry

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Mucormycosis as a complication of COVID-19 coronavirus infection: eye symptoms

Babushkin,

Gilemzianova,

Ponomarev

2024

Rossijskij oftalʹmologičeskij žurnal

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COVID-19 causes an immunosuppressive condition and increases the risk of secondary infections, including fungal diseases such as mucormycosis (MM), so doctors should be aware of the possibility of MM development in COVID-19 patients. Since no specific complaints or clinical symptoms exist and the disease is rare, especially in developed countries with a moderate climate, it is often impossible to diagnose MM at the initial examination. Therefore, the detection of the pathogen (mycelium zygomycetes) plays a key role in the diagnosis. Over 70 % of MM patients experience eye damages. According to the literature, the most common manifestations thereof are blepharoptosis, ophthalmoplegia, exophthalmos, injection and conjunctival chemosis. Quite often, the patients have eye pains, orbital cellulitis or phlegmon of the orbit, accompanied by a decrease in vision. For the effective treatment of this severe infectious COVID-19 complication, which takes the form of deep and aggressive mycosis, an interdisciplinary approach is necessary. The complex treatment should make use of antimycotic agents and symptomatic therapy, and, essentially, surgical rehabilitation of infection foci by removing the affected necrotic tissues. The prognosis is always very serious.

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Rhinoorbital mucormycosis in patients with the post-COVID syndrome. Clinical and morphological features

Cited by 2 publications

References 25 publications

Differences in the Microbiological Picture in Patients With Post-Covid Osteonecrosis of the Maxillofacial Region and the Risk Group for This Complication

Differences in the Microbiological Picture in Patients With Post-Covid Osteonecrosis of the Maxillofacial Region and the Risk Group for This Complication

Mucormycosis as a complication of COVID-19 coronavirus infection: eye symptoms

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