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Updated: Jun 14, 2026

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Pictorial Review of Post COVID-19 Acute Invasive Fungal Sinusitis: Clinical Radiologists' Perspective.

Noamaan Muhammed1,2, Sneha Hiriyanna3,2, Ravikanti S Prasad4

  • 1Department of Radiology, Teleradiology Solutions, Bengaluru, 560048 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|March 5, 2024
PubMed
Summary

Acute invasive fungal sinusitis (AIFS) is increasing post-COVID-19. This study details CT and MRI findings, crucial for timely surgical intervention in these immunocompromised patients.

Keywords:
Acute invasive fungal mycosesImaging featuresMucormycosisPost COVID-19

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Area of Science:

  • Medical Imaging
  • Infectious Diseases
  • Otolaryngology

Background:

  • Acute invasive fungal sinusitis (AIFS) is a severe infection, with rising cases post-COVID-19.
  • Limited literature exists on imaging findings in post-COVID-19 AIFS patients.
  • Accurate imaging is vital for prompt surgical management.

Purpose of the Study:

  • To elucidate the spectrum of cross-sectional imaging findings (CT and MRI) in patients with post-COVID-19 AIFS.
  • To correlate imaging findings with clinical presentation and follow-up data.
  • To emphasize the radiologist's role in guiding timely therapeutic interventions.

Main Methods:

  • Retrospective review of 31 histopathologically confirmed post-COVID-19 AIFS cases.
  • Analysis of CT and MRI imaging, including nasal cavity, paranasal sinuses, orbits, and brain.
  • Inclusion of 90-day patient follow-up data and descriptive statistical analysis.

Main Results:

  • Nasal cavity involvement in all cases; maxillary (100%) and ethmoid (93.5%) sinuses most affected.
  • MR showed mucosal enhancement loss; maxillary sinus wall erosion in 90%.
  • Rhino-orbital (77%), rhino-orbito-cerebral (45%) mycosis, and optic nerve involvement (48%) were observed.

Conclusions:

  • Imaging findings in post-COVID-19 AIFS are diverse, including extensive sinus and orbital involvement.
  • Radiologists play a critical role in identifying disease extent, guiding surgical and medical management.
  • Early recognition of imaging features is essential to prevent severe complications and improve patient outcomes.