Fungal sinusitis post COVID 19 – A case series from a diagnostic microbiology laboratory

Abstract

Fungal infections are on rise globally owing to use of immunosuppressant drugs for various diseases, increased use of antimicrobials and in-situ devices, long duration of stay in hospitalized patients. There was sharp rise in mucormycosis infections in patients post COVID 19 illness which were previously limited to patients of end stage diabetic ketoacidosis. We studied the epidemiological, clinical, microbiological and radiological aspects for culture positive cases of fungal sinusitis from April 2021 to June 2021. The mean age of our patients was 55.4 years (range 38 to 70 years). M:F ratio was 1.5:1. All fungal infections occurred in laboratory and/or radiologically diagnosed cases of COVID 1970% patients (n=7) had diabetes mellitus as co-morbidity. 60% of the cases (n=6) grew Rhizopus arrhizus, 30% grew Aspergillus species (n=3) and 10% grew Penicillium species (n=1). 90% of the cases (n=9) improved after treatment whereas 10% (n=1) succumbed to the illness.Along with rhino-orbito-cerebral mucormycosis infections, nasal aspergillosis was also noted as a prominent cause of fungal sinusitis in post COVID 19 illness. As the antifungal therapy for these two fungal infections differs significantly, caution must be adhered to while diagnosing and treating.