Maxillary Mucormycosis Osteomyelitis in Post COVID-19 Patients: A Series of Fourteen Cases

Ahmed, Wael Mohamed Said; Elsherbini, Amira M.; Elsherbiny, Nehal M.; El‐Sherbiny, Mohamed; Ramzy, N.; Arafa, Ahmed F.

doi:10.3390/diagnostics11112050

Cited by 19 publications

(12 citation statements)

References 16 publications

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“…[ 65 ] Czech Case series Multi-center 6 Apr 2021–May 2021 [47–68] 71 (5) 83 (5) Said Ahmed WM. [ 66 ] Egypt Case series Single-center 14 – [29–77] 71 (10) 100 (14) Alloush TK. [ 67 ] Egypt Case series Single-center 14 May 2021–Jun 2021 [49–82] 64 (9) 93 (!3) Seidel D. [ 68 ] Germany Case series Multi-center 13 Feb 2020–Jun 2021 [30–75] 62 (8) 23 (3) Author HTN, % (N) CKD, % (N) Immunosuppression, % (N) Malignancy, % (N) Hypoxia, % (N) Mechanical ventilation, % (N) Corticosteroids treatment, % (N) ICU admission, % (N) Moorthy A.…”

Section: Resultsmentioning

confidence: 99%

“…[ 65 ] 17 (1) – – 50 (3) – 100 (6) – Said Ahmed WM. [ 66 ] – – – – – – 21 (3) Alloush TK. [ 67 ] 43 (6) 14 (2) – 100 (14) 0 (0) 93 (13) – Seidel D. [ 68 ] – 7.7 (1) 38 (5) – 79 (11) 79 (11) 79 (11) Value is shown as mean ± SD or median [range].…”

Section: Resultsmentioning

confidence: 99%

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Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Watanabe

Mitaka

et al. 2022

Mycopathologia

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The recent increase of COVID-19-associated mucormycosis (CAM) has been commanding global attention. However, basic epidemiologic characteristics have not firmly been established. In this systematic review and meta-analysis, we sought to determine the clinical manifestations, potential risk factors, and outcomes of CAM. Observational studies reporting CAM were searched with PubMed and EMBASE databases in January 2022. We collected data on comorbidities and treatment for COVID-19, and performed a one-group meta-analysis on the frequency of orbital exenteration procedure and mortality of CAM using a random-effect model. Fifty-one observational studies, including a total of 2,312 patients with proven CAM, were identified. Among the 51 studies, 37 were conducted in India, 8 in Egypt, and 6 in other countries. The most common comorbidity was diabetes mellitus (82%). While 57% required oxygenation, 77% received systemic corticosteroids. Among CAM, 97% were rhino-orbital-cerebral (ROCM), and 2.7% were pulmonary mucormycosis. Usual presentations were headache (54%), periorbital swelling/pain (53%), facial swelling/pain (43%), ophthalmoplegia (42%), proptosis (41%), and nasal discharge/congestion (36%). Regarding the outcomes, orbital exenteration was performed in 17% (95% CI: 12–21%, I 2 = 83%) of the COVID-19-associated ROCM patients. The mortality of CAM was 29% (95% CI; 22–36%, I 2 = 92%). In conclusion, this systematic review and meta-analysis indicated that the most prevalent type of CAM was ROCM, and most CAM patients had diabetes mellitus and received systemic glucocorticoids. Clinicians in the endemic areas should have a high index of suspicion for this invasive fungal complication of COVID-19 when a diabetic patient who received high-dose systemic glucocorticoids developed rhino-orbital symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Watanabe

Mitaka

et al. 2022

Mycopathologia

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“…Recent COVID-related manifestations of maxillary mucormycosis osteomyelitis have a distinct pattern of facial bone involvement similar to that of our case. One case series reported 14 patients with comorbid COVID and diabetes presented with various mucor involvement of the maxilla, zygoma, and orbital rim [8] . Another similar case demonstrated mucormycotic osteomyelitis of the nasomaxillary-zygomatic complex following trauma in a middle-aged man [9] .…”

Section: Discussionmentioning

confidence: 99%

Extent of craniofacial fungal osteomyelitis in a ketoacidotic patient may predict optic nerve involvement: A case report

Adams

Sheikh

Bender‐Heine

2022

International Journal of Surgery Case Reports

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“…Despite the low doses of corticosteroid used, further studies have shown some unwanted side effects. In fact, a growing number of reports on emerging systemic fungal infections concomitant with COVID-19 has been published [ 39 , 40 , 41 , 42 , 43 ], raising concerns about the risk of immunosuppression due to both corticosteroids, particularly among the high-risk populations (diabetes, obesity, and aging).…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic Study of Intranasal Dexamethasone and Methylprednisolone Compared with Intravenous Administration: Two Open-Label, Single-Dose, Two-Period, Two-Sequence, Cross-Over Study in Healthy Volunteers

Cárdenas

Bobes²,

Fragoso³

et al. 2022

Pharmaceutics

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Dexamethasone (DXM) and methylprednisolone (MEP) are potent glucocorticoids used to control several inflammatory conditions. Evidence of delayed DXM reaching the central nervous system (CNS) as well as tachyphylaxis and systemic, undesirable side effects are the main limitations of peripheral delivery. Intranasal administration offers direct access to the brain as it bypasses the blood–brain barrier. The Mucosal Atomization Device is an optimal tool that can achieve rapid absorption into the CNS and the bloodstream across mucosal membranes. This study was designed to evaluate and compare the bioavailability of DXM and MEP after intranasal versus intravenous administration. Two open-label, balanced, randomized, two-treatment, two-period, two-sequence, single-dose, crossover studies were conducted, which involved healthy male and female adult volunteers. After intranasal administration, DXM and MEP were detected in plasma after the first sampling time. Mean peak concentrations of DXM and MEP were 86.61 ng/mL at 60 min and 843.2 ng/mL at 1.5 h post-administration, respectively. DXM and MEP showed high absolute bioavailability, with values of 80% and 95%, respectively. No adverse effects were observed. DXM and MEP systemic bioavailability by intranasal administration was comparable with the intravenous one, suggesting that the intranasal route can be used as a non-invasive and appropriate alternative for systemic drug delivery.

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Maxillary Mucormycosis Osteomyelitis in Post COVID-19 Patients: A Series of Fourteen Cases

Cited by 19 publications

References 16 publications

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis

Extent of craniofacial fungal osteomyelitis in a ketoacidotic patient may predict optic nerve involvement: A case report

Pharmacokinetic Study of Intranasal Dexamethasone and Methylprednisolone Compared with Intravenous Administration: Two Open-Label, Single-Dose, Two-Period, Two-Sequence, Cross-Over Study in Healthy Volunteers

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