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Published on: December 19, 2020
Radiological review of rhinocerebral mucormycosis cases during the COVID-19 Pandemic: A single-center experience
P S Saneesh1, Satya Chowdary Morampudi2, Raghav Yelamanchi3
1Department of Radiology, Aster MIMS, Kannur 670007, Kerala, India.
Abstract:
Mucormycosis is caused by the fungi belonging to the order Mucorales and class Zygomycetes. The incidence of mucormycosis has increased with the onset of the severe acute respiratory syndrome coronavirus 2 infections leading to the coronavirus disease 2019 (COVID-19) pandemic. This rise is attributed to the use of immunosuppressive medication to treat COVID-19 infections. Authors have retrospectively collected data of our cases of mucormycosis diagnosed from April 2020 to April 2021 at our institute. A total of 20 patients with rhinocerebral mucormycosis were studied. Most of the study subjects were male patients (90%) and were of the age group 41-50 years. Most patients in the review had comorbidities (85%) with diabetes being the most common comorbidity. Para nasal sinuses were involved in all the cases. Involvement of the neck spaces was present in 60% of the cases. Involvement of the central nervous system was present in 80% of the cases. Orbital involvement was present in 90% of the cases. The authors reviewed the various imaging findings of mucormycosis on computed tomography and magnetic resonance imaging in this article.
Insights
Mucormycosis, a fungal infection, surged during the COVID-19 pandemic due to immunosuppressive treatments. This study highlights rhinocerebral mucormycosis in 20 patients, detailing common imaging findings and risk factors like diabetes.
Area of Science:
- Mycology
- Infectious Diseases
- Radiology
Background:
- Mucormycosis is a severe fungal infection caused by Mucorales.
- The COVID-19 pandemic saw increased mucormycosis incidence, linked to immunosuppressive therapies.
- Rhinocerebral mucormycosis is a particularly aggressive form.
Purpose of the Study:
- To analyze the clinical and imaging characteristics of rhinocerebral mucormycosis.
- To correlate imaging findings with disease extent in COVID-19-associated cases.
- To review computed tomography (CT) and magnetic resonance imaging (MRI) findings.
Main Methods:
- Retrospective data collection of 20 mucormycosis patients from April 2020 to April 2021.
- Analysis of patient demographics, comorbidities, and clinical presentation.
- Review of CT and MRI imaging findings for paranasal sinuses, central nervous system, orbits, and neck spaces.
Main Results:
- The study included 20 patients, predominantly male (90%) aged 41-50 years.
- Diabetes was the most common comorbidity (85%).
- High rates of involvement were observed: paranasal sinuses (100%), orbits (90%), central nervous system (80%), and neck spaces (60%).
Conclusions:
- Rhinocerebral mucormycosis presents with extensive involvement of sinuses, orbits, and CNS, especially in diabetic patients.
- CT and MRI are crucial for diagnosing and assessing the extent of mucormycosis.
- The findings underscore the severity and diagnostic imaging importance of this opportunistic infection in the context of COVID-19.
