Abstract

SHUKLA, Varun  and  SHETTY, Sujeeth. Unmasking the uncommon: post covid-19's sinister encore. A clinical report of acute invasive fungal rhinosinusitis in a non-diabetic, non-steroid therapy patient. Rev Esp Cirug Oral y Maxilofac [online]. 2023, vol.45, n.2, pp.79-82.  Epub Nov 20, 2023. ISSN 2173-9161.  https://dx.doi.org/10.20986/recom.2023.1464/2023.

COVID-19, caused by SARS-CoV-2, has been linked to various bacterial and fungal infections. The incidence of mucormycosis has notably increased in individuals with COVID-19, with many cases reported globally, especially in India. The risk factors for developing mucormycosis include uncontrolled diabetes and use of immunosuppressants such as corticosteroids. We report a case of acute invasive fungal rhino-sinusitis (mucormycosis) in a 42 year old patient with no history of diabetes or steroid therapy but recently diagnosed with COVID-19. The patient presented with facial swelling, loose teeth, and imaging findings consistent with mucormycosis. The history, examination, and laboratory investigations were sufficient to exclude other causes of immunocompromised status in the patient. The diagnosis was confirmed through KOH staining of excised tissue, which tested positive for mucor. The patient underwent systemic antifungal therapy and Functional Endoscopic Sinus surgery (FESS) associated with a bilateral maxillectomy to remove the affected tissue. These interventions were successful, and the patient experienced a positive clinical response.

This case report details an uncommon presentation of post COVID-19 acute invasive fungal rhino-sinusitis in a patient without typical risk factors for the infection. Therefore, clinicians should have a high index of suspicion for mucormycosis in patients with a recent history of COVID-19 infection, especially those with symptoms such as facial swelling or tooth loss. Prompt detection and management of mucormycosis are critical for improving patient outcomes. However, delays in diagnosis and treatment can lead to significant morbidity and mortality.

Keywords : Fungal infection; mucorales; opportunistic pathogen; immunocompromised; surgical intervention.

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