COVID‐19‐associated acute invasive fungal sinusitis: Clinical and imaging findings

Elmokadem, Ali H.; Bayoumi, Dalia; Mansour, Manar; Ghonim, Mahitab; Saad, Eman Ashraf; Khedr, Doaa

doi:10.1111/jon.12967

Cited by 9 publications

(11 citation statements)

References 49 publications

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“…In literature today, we still lack published statistical data about rhinosinusitis in patients in post-COVID-19 period [15]. The etiopathogenesis of such pathology is not well studied.…”

Section: Introductionmentioning

confidence: 99%

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Myroshnychenko

Kalashnyk-Vakulenko

Kapustnyk³

et al. 2022

Wiad Lek

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The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.

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“…In literature today, we still lack published statistical data about rhinosinusitis in patients in post-COVID-19 period [15]. The etiopathogenesis of such pathology is not well studied.…”

Section: Introductionmentioning

confidence: 99%

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Myroshnychenko

Kalashnyk-Vakulenko

Kapustnyk³

et al. 2022

Wiad Lek

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“…To con rm the diagnosis, detecting fungal strains by assessment of CSF sample or soft tissue biopsy is necessary (9). In this regard, visualization of fungus under direct microscopy, its culture, or molecular assessment can lead to con rming the diagnosis (20).…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 rhinocerebral mucormycosis, a life-threatening event in the background of immunosuppressive condition: A case report

Tajik

Chegini

2023

Preprint

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Introduction: In patients suffering from COVID-19, immunocompromised conditions or immunosuppressive medications such as corticosteroids may predispose them to early or delayed invasive fungal infections that invade cerebral components. This study, for the first time, describes a case of COVID-19 disease diagnosed with rhinocerebral mucormycosis through cerebrospinal fluid (CSF) analysis. Case presentation: A 32-year-old woman with a history of referral and hospitalization due to COVID-19 about a month ago was being treated with immunosuppressive drugs, manifested by lower extremity plegia. In the imaging assessment, intracranial hemorrhage (thalamus zone) and mass like lesion were revealed. In cytological assessment, acute inflammations associated with fungal infection in accordance with the diagnosis of mucormycosis were definitively confirmed. Despite antifungal medication, consciousness declined one week later, and the patient developed thromboembolism and died. Conclusion In patients with a COVID-19 background of immunosuppressive therapy or clinical situations related to immunosuppression such as uncontrolled diabetes, rhinocerebral mucormycosis will always be an ambush. Therefore, screening and prevention measures should be considered.

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“…MRI imaging findings include thickening of mucosa, opaque paranasal sinuses, hypertrophied nasal turbinates and “black turbinate sign” (nonenhancing soft tissue within the affected turbinate). [ 17 ] Extension into the orbit, cavernous sinus, infratemporal fossa, skull base, and intracranial compartment is also noted.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

Gupta

Gupta²,

Kayarat³

2023

Saudi J Anaesth

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Mucormycosis once considered a rare disease with an incidence of 0.005 to 1.7 per million, has become one of the greatest menaces during the coronavirus disease (COVID-19) pandemic. India alone has contributed to nearly 70% of the global caseload of COVID-associated mucormycosis (CAM) and it had even been declared as a notifiable disease. Second wave of COVID-19 pandemic saw a steep rise in the incidence of mucormycosis and these patients have been presenting to anesthesiologists for various surgical procedures due to its primary or secondary sequelae. Rhino-orbito-cerebral mucormycosis (ROCM) is the commonest manifestation and is caused by Rhizopus arrhizus. Injudicious use of corticosteroids in vulnerable patients could have been a major contributing factor to the sudden rise in ROCM during the pandemic. Concerns related to anesthetic management include COVID-19 infection and post COVID sequalae, common presence of uncontrolled diabetes mellitus, possibility of difficult mask-ventilation and/or intubation, various drug therapy-associated adverse effects, and interaction of these drugs with anesthetic agents. Thorough preoperative optimization, multidisciplinary involvement, perioperative care, and vigilance go a long way in improving overall outcomes in these patients.

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COVID‐19‐associated acute invasive fungal sinusitis: Clinical and imaging findings

Cited by 9 publications

References 49 publications

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Post-COVID-19 rhinocerebral mucormycosis, a life-threatening event in the background of immunosuppressive condition: A case report

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

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