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World J Radiol. Jul 28, 2022; 14(7): 209-218
Published online Jul 28, 2022. doi: 10.4329/wjr.v14.i7.209
Radiological review of rhinocerebral mucormycosis cases during the COVID-19 Pandemic: A single-center experience
P S Saneesh, Satya Chowdary Morampudi, Raghav Yelamanchi
P S Saneesh, Department of Radiology, Aster MIMS, Kannur 670007, Kerala, India
Satya Chowdary Morampudi, Department of Radiodiagnosis, Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Gannavaram 521101, Andhra Pradesh, India
Raghav Yelamanchi, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, Delhi, India
Author contributions: Saneesh PS analyzed the data; Morampudi SC analyzed the data and wrote the manuscript; Yelamanchi R analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: None of the authors in the study have any conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raghav Yelamanchi, DNB, MS, Surgeon, Surgical Oncologist, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, Delhi, India. raghavyelamanchi@gmail.com
Received: March 28, 2022
Peer-review started: March 28, 2022
First decision: May 12, 2022
Revised: June 9, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: July 28, 2022
Abstract

Mucormycosis is caused by the fungi belonging to the order Mucorales and class Zygomycetes. The incidence of mucormycosis has increased with the onset of the severe acute respiratory syndrome coronavirus 2 infections leading to the coronavirus disease 2019 (COVID-19) pandemic. This rise is attributed to the use of immunosuppressive medication to treat COVID-19 infections. Authors have retrospectively collected data of our cases of mucormycosis diagnosed from April 2020 to April 2021 at our institute. A total of 20 patients with rhinocerebral mucormycosis were studied. Most of the study subjects were male patients (90%) and were of the age group 41-50 years. Most patients in the review had comorbidities (85%) with diabetes being the most common comorbidity. Para nasal sinuses were involved in all the cases. Involvement of the neck spaces was present in 60% of the cases. Involvement of the central nervous system was present in 80% of the cases. Orbital involvement was present in 90% of the cases. The authors reviewed the various imaging findings of mucormycosis on computed tomography and magnetic resonance imaging in this article.

Keywords: Mucormycosis, Rhinocerebral infections, Fungal sinusitis, Medical imaging, Radiodiagnosis, COVID-19 pandemic

Core Tip: Rhinocerebral mucormycosis constituted the aftermath of the coronavirus disease 2019 pandemic, leading to rapid increase in the number of cases, which were previously restricted only to few susceptible groups of patients. Rhinocerebral mucormycosis is associated with high mortality and morbidity. After clinical examination, imaging is the backbone for the diagnosis of this severe disease. Computed tomography helps in the preliminary diagnosis and helps to stage the disease. However, when orbital and intracranial extension is present, magnetic resonance imaging (MRI) is preferred because it delineates the involvement of these structures better. MRI can also delineate vascular involvement better. This article reviews the various imaging findings of mucormycosis.