Premaxillary and maxillary sinus mucormycosis post COVID: a rare case report

Authors

  • Deependra Shrestha Department of ENT and Head and Neck Surgery, Norvic International Hospital, Kathmandu, Nepal http://orcid.org/0000-0003-3923-1423
  • Reskey Dev Department of ENT and Head and Neck Surgery, Norvic International Hospital, Kathmandu, Nepal

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20214687

Keywords:

Mucormycosis, COVID-19, Sinonasal disease

Abstract

Mucormycosis, previously termed as zygomycosis, is an opportunistic infection and is caused by fungi belonging to the order Mucorales. It is found in patients with predisposing conditions such as diabetic ketoacidosis, chronic kidney disease malignancy long-term steroid use and immunosuppressant drugs. Mucormycosis involving paranasal sinuses is a rare life-threatening opportunistic infection in a covid positive patient. The unprescribed use of corticosteroid in covid positive patient, the lymphopenia in severe covid 19 cases, preexisting diseases like uncontrolled diabetes mellitus, hematological malignancy, stem cell transplant causing weak immune system are the factors which are responsible for mucor infection in covid positive patients. We herein report the case of maxillary and premaxillary mucormycosis infection in the uncontrolled diabetic patient with post covid status in recovering phase of acute respiratory distress syndrome.

Author Biographies

Deependra Shrestha, Department of ENT and Head and Neck Surgery, Norvic International Hospital, Kathmandu, Nepal

Consultant ENT

Reskey Dev, Department of ENT and Head and Neck Surgery, Norvic International Hospital, Kathmandu, Nepal

Professor and department head national ENT Center

References

UNCTAD. Impact of the COVID-19 pandemic on trade and development: transitioning to a new normal. Available at: https://unctad.org/webflyer/ impact-covid-19-pandemic-trade-and-development-transitioning-new-normal. Accessed on 10 Jan, 2021.

Agarwal SL. What We Know about India’s Covid-19 Variant B.1.617. Available at: https://www.wsj.com/ articles/what-we-know-about-indias-double-mutant-covid-19-variant-11619193481. Accessed on 10 Jan, 2021.

Biswas S. Mucormycosis: The 'black fungus' maiming Covid patients in India. Available at: https://www.bbc.com/news/world-asia-india-57027829. Accessed on 10 Jan, 2021.

CDC. Where Mucormycosis comes from. Available at: https://www.cdc.gov/fungal/diseases/ mucormycosis/causes.html#:~:text=Mucormycetes%2C%20the%20group%20of%20fungi,than%20in%20winter%20or%20spring. Accessed on 10 Jan, 2021.

Mekonnen ZK, Ashraf DC, Jankowski T, Grob SR, Vagefi MR, Kersten RC. Acute Invasive Rhino-Orbital Mucormycosis in a Patient with COVID-19-Associated Acute Respiratory Distress Syndrome Ophthalmic. Plast Reconstr Surg. 2021;37(2):e40-80.

Methylprednisolone for patients with COVID-19 severe acute respiratory syndrome-full text view ClinicalTrials.gov. Available at: https://clinicaltrials.gov/ct2/show/NCT04323592. Accessed on 10 Jan, 2021.

Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med. 2021;42:264.e5-264.e8.

Chen X, Liao B, Cheng L, Peng X, Xu X, Li Y, et al. The microbial coinfection in COVID-19. Appl Microbiol Biotechnol. 2020;104(18):7777-85.

Gangneux JP, Bougnoux ME, Dannaoui E, Cornet M, Zahar JR. Invasive fungal diseases during COVID-19: we should be prepared. J Mycol Med. 2020;30:100971.

White PL, Dhillon R, Cordey A. A national strategy to diagnose COVID-19 associated invasive fungal disease in the ICU. Clin Infect Dis. 2020;73(7):e1634-44.

Iyer M. Zinc overuse driving black fungus epidemic within pandemic? Doctors want study. Available at: https://timesofindia.indiatimes.com/city/mumbai/mumbai-zinc-overuse-driving-mucor-epidemic-within-pandemic-docs-want-study/articleshow/82922957. cms. Accessed on 10 Jan, 2021.

McNab AA, McKelvie P. Iron Overload Is a Risk Factor for Zygomycosis Arch Ophthalmol. 1997;115(7):919-21.

Black fungus, white fungus, yellow fungus: What we know about post-Covid infections. Available at: https://www.hindustantimes.com/india-news/black-fungus-white-fungus-yellow-fungus-what-we-know-about-post-covid-infections-101622102847311.html. Accessed on 10 Jan, 2021.

Safi M, Ang MJ, Patel P. Silkiss Rhino-orbital-cerebral mucormycosis (ROCM) and associated cerebritis treated with adjuvant retrobulbar amphotericin B. Am J Ophthalmol Case Rep. 2020;19:100771.

Kolekar JS. Rhinocerebral mucormycosis: a retrospective study Indian J. Otolaryngol. Head Neck Surg. 2015;67(1);93-6.

Camara-Lemarroy CR, González-Moreno R, Rodríguez-Gutiérrez EJ, Rendón-Ramírez AS, Ayala-Cortés ML, Fraga-Hernández L et al. Clinical features and outcome of mucormycosis Interdiscip. Perspect Infect Dis. 2014;562610.

Talmi YP, Goldschmied-Reouven M, Bakon I, Barshack M, Wolf Z, Horowitz A et al. Rhino-orbital and rhino-orbito-cerebral mucormycosis Otolaryngol. Head Neck Surg. 2002;127(1):22-31.

Gupta SR, Goyal NM, Kaore M. Rhino-orbital-cerebral mucormycosis: battle with the deadly enemy Indian J. Otolaryngol. Head Neck Surg. 2020;72(1):104-11.

Groote CA. Rhinocerebral phycomycosis. Arch Otolaryngol. 1970;92(3):288-92.

Bawankar P, Lahane S, Pathak P, Gonde P, Singh A. Central retinal artery occlusion as the presenting manifestation of invasive rhino-orbital-cerebral mucormycosis Taiwan J Ophthalmol. 2020;10(1):62-5.

Parsi K, Itgampalli RK, Vittal R, Kumar A. Perineural spread of rhino-orbitocerebral mucormycosis caused by Apophysomyces elegans Ann. Indian Acad. Neurol. 2013;16(3):414.

Deutsch PG, Whittaker J, Prasad S. Invasive and non-invasive fungal rhinosinusitis-a review and update of the evidence. Medicina. 2019;55:1-14.

Herrera DA, Dublin AB, Ormsby EL, Aminpour S, Howell LP. Imaging findings of rhinocerebral mucormycosis. Skull base. 2019;19(2):117-25.

Therakathu J, Prabhu S, Irodi A, Sudhakar SV, Yadav VK, Rupa V. Imaging features of rhinocerebral mucormycosis: a study of 43 patients. Egypt J Radiol Nuclear Med. 2018;49(2):447-52.

Downloads

Published

2021-11-25

Issue

Section

Case Reports