A case series of 99mTc-MDP bone scintigraphy (planar and SPECT CT) in mucormycosis in the era of COVID 19

Mucormycosis is a serious fungal infection affecting immunocompromised individuals, caused by fungi from the Mucorales order, particularly Rhizopus species. It primarily spreads through inhalation of spores, with diabetes, cancers, organ transplants, immunosuppressive drugs, and COVID-19 being major risk factors. The infection manifests in various forms such as encephalic, cutaneous, gastrointestinal, pulmonary, and rhino cerebral, often leading to tissue necrosis and blood vessel invasion. Imaging diagnosis is aided by CT and MRI scans, while 99m Tc MDP bone scintigraphy has found to be a more accurate imaging tool to look for bone remodelling and erosive changes associated with invasive fungal sinusitis including mucormycosis. Treatment involves prompt surgical debridement and addressing the underlying immune deficiency. Here we present a series of cases where 99m Tc MDP bone scintigraphy played a key role in management of mucormycosis of the head. In conclusion, 99mTc MDP scintigraphy is a promising tool for evaluation, guiding diagnosis and management of mucormycosis.