Archives of Academic Emergency Medicine (Aug 2022)

Distinguishing Characteristics of COVID-19-Associated Mucormycosis; a Case Series

  • Seyedhadi Samimiardestani,
  • Shirin Irani,
  • Mehrdad Hasibi,
  • Maral Seyedahadi,
  • Shahin Bastaninejad,
  • Mohammadreza Firouzifar,
  • Mojataba Mohammadi Ardehali,
  • Sina Berijani,
  • Reza Erfanian,
  • Mohammad Ali Kazemi,
  • Afshar Etemadi-Aleagha,
  • Abolfazl Rahimi,
  • Kourosh Karimi Yarandi,
  • Samira Ahadi

DOI
https://doi.org/10.22037/aaem.v10i1.1644
Journal volume & issue
Vol. 10, no. 1

Abstract

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Introduction: Since the emergence of COVID-19 pandemic, several articles have reported the co-existence of mucormycosis and COVID-19. This study aimed to distinguish the characteristics of COVID-19-associated rhinocerebral mucormycosis. Methods: In this case series, 18 patients with COVID-19-associated rhinocerebral mucormycosis and unique clinical manifestations and outcomes, who were referred to Amiralam Hospital, a tertiary otorhinolaryngology center, Tehran, Iran, during the COVID-19 era, were reported. Results: Eighteen patients with the mean age of 62.0 ± 11.6 (range: 42 – 83) years were studied (50% males). The mean time interval between diagnosis of COVID-19 and first manifestation of mucormycosis was 15.5 ± 9.7 days. The most common presenting symptom was facial paresthesia (72.2%). Fifty percent of patients developed frozen eye. Palatal necrosis was seen in 7 cases (38.8%). Remarkably, facial paralysis was observed in 5 (27.7%) patients. Another notable clinical picture was cavernous sinus thrombosis, seen in 7 patients. We also had two cases of carotid artery occlusion. Three patients, unfortunately, passed away. Conclusion: Rhinocerebral mucormycosis is one of the most important complications of COVID-19 patients, especially those with underlying diseases. It seems that the key to proper management of mucormycosis is early diagnosis and timely intervention, which could give a patient a chance to live more.

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