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Home > Archives > Volume 20, No 8 (2022) > Article

DOI: 10.14704/nq.2022.20.8.NQ44760

RADIOLOGICAL SPECTRUM OF SINONASAL MUCORMYCOSIS IN COVID POSITIVE PATIENTS

Kumar Snehil, Tamboli Asif I, Bhoite Amol S, Bawage Radha R, Jagtap Apurva, Gautam Amol A

Abstract

Rationale and Objectives - At present, sinonasal mucormycosis is most worrisome COVID-19 related complication in India while western countries have relatively stayed aloof. But given the pervasive nature of fungi and presence of all predisposing conditions even in western countries, it is imperative to have knowledge about the imaging patterns and staging of the disease. In this study, we try to single out factors responsible for the sudden increment in the incidence of sinonasal mucormycosis among covid-19 patients and discuss their imaging features. Patients and Methods - The case records of 30 patients, between January to May, 2021, with positive RT-PCR for COVID-19 and biopsy proven sinonasal mucormycosis were retrospectively evaluated. Results – Out of 30 patients, 28 had raised random blood glucose level and 24 had raised ferritin level. On imaging, nasal cavity involvement was seen in 18 patients. Paranasal sinuses were involved in 28 patients. The disease process also showed involvement of orbit, neck spaces and intracranial extension. We divided sinonasal mucormycosis into four groups and mortality was seen in patients of stage 3 and 4 (total mortality was 26.7%). Conclusion - MRI played an important role in diagnosis and staging of sinonasal mucormycosis as well as determining the extrasinus extent of disease. Mortality was seen in patients presenting in advanced stage of the disease, with orbital or intracranial extension. Thus, it is imperative that high index of suspicion, early imaging with diagnosis and aggressive management protocol needed to reduce morbidity and mortality.

Keywords

sinonasal mucormycosis, COVID-19, MRI, staging, risk factors, orbit

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