Case series of post-COVID-19 rhino-orbito cerebral mucormycosis in Egypt

Objectives: To identify and recognize clinical characteristics, pathophysiology, and management of a group of patients with rhino-orbito-cerebral mucormycosis infection associated with COVID-19 viral infection. Methods: Study included 35 patients aged range (12-71 years) with rhino-orbito-cerebral mucormycosis infection associated with COVID-19, who were admitted to our oral and maxillofacial department from January 2020 to April 2021. These patients were either referred by the E.N.T and ophthalmology departments or presented firstly to our oral and maxillofacial department. All patients were diagnosed clinically and radiographically. Results: Twenty-one (60%) males and 14 (40%) females, mean age was 44.17 years, 18 patients presented with COVID-19 and 17 patients presented to our hospital post healing with history of using large doses of systemic corticosteroids. patients were managed by aggressive surgical debridement, antifungal drugs amphotericin B and adjunctive treatment like local irrigation with amphotericin B and hyperbaric oxygen according to systemic conditions of patients. Hyperbaric oxygen was used in five patients post-surgically. All investigations were done with mean values of blood glucose level, hemoglobin and WBC were noticeably abnormal. The degree of severity, length of stay, and mortality rate were significantly correlated with the severity of systemic predisposing factors. Conclusions: Mucormycosis is an invasive fungal infection, often acute and extremely severe, occurring in patients with an underlying systemic condition. It is considered to be a Coinfection in patients with coronavirus disease (COVID-19).