Original Articles
Role of magnetic resonance imaging in evaluating post-covid-19 patients with rhino-orbito-cerebralmucormycosis: A study of 72 patients | |
Sujith Rajashekar Swamy, Arikila Mounika, Shreelatha A | |
Introduction: Patients with COVID-19 pneumonia are predisposed to fungal infections due to alteration of cell mediated immunity and over expression of inflammatory cytokines. Other predisposing factors include diabetes mellitus, aggressive use of systemic steroids, and other such immunosuppressive conditions. Contrast enhanced Magnetic Resonance Imaging (CE-MRI) serve as important imaging modality to assess the extent of involvement and to look for complications, if any, which are quite common.Objectives: The objective of the present study was to describe the myriad of imaging findings in Rhino Orbital Cerebral Mucormycosis (ROCM) in Post covid-19 patients and an attempt to stage the disease.Materials and Methods: We conducted a cross sectional study on 72 patients with ROCM from May 2021 to August 2021,who were subjected to a CE-MRI of the paranasal sinuses and orbit. The clinical and radiographic data were collected and analysed. Results: Among Covid-19 infected patients, mucormycosis affected more frequently the patients with predisposing conditions like diabetes (47 patients ~65%) followed by other immuno-compromised conditions. On MRI most patients (72.2%), were found to have stage 3 disease and maxillary sinus is the most frequently involved sinus. Orbital involvement is the most common involved extra sinus site followed by intracranial extension and skull base osteomyelitis. Most frequent intracranial complication was meningitis.Conclusion: MRI plays an important role in evaluating the extent of disease, various complications, and pathologies to be searched in a case of ROCM. COVID19 associated mucormycosis shows a frequent spread of infection to extra sinus sites and is associated especially with uncontrolled diabetes, steroid administration and oxygen supplementation. Hence, imaging plays a vital role in assessing the extent of the disease, its aggressive to management and timely intervention and thus helps in reducing the morbidity and mortality of patients. |
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