Samimiardestani Seyedhadi, Irani Shirin, Hasibi Mehrdad, Seyedahadi Maral, Bastaninejad Shahin, Firouzifar Mohammadreza, Mohammadi Ardehali Mojataba, Berijani Sina, Erfanian Reza, Kazemi Mohammad Ali, Etemadi-Aleagha Afshar, Rahimi Abolfazl, Karimi Yarandi Kourosh, Ahadi Samira
Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Infectious Disease Department, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2022 Aug 18;10(1):e66. doi: 10.22037/aaem.v10i1.1644. eCollection 2022.
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.
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.
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.
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.
自新冠疫情出现以来，多篇文章报道了毛霉菌病与新冠病毒病的共存情况。本研究旨在明确新冠病毒病相关鼻脑型毛霉菌病的特征。
在本病例系列中，报告了18例在新冠疫情期间转诊至伊朗德黑兰三级耳鼻喉科中心阿米拉勒姆医院的新冠病毒病相关鼻脑型毛霉菌病患者，他们具有独特的临床表现和结局。
对18例平均年龄为62.0±11.6岁（范围：42 - 83岁）的患者进行了研究（50%为男性）。新冠病毒病诊断与毛霉菌病首次表现之间的平均时间间隔为15.5±9.7天。最常见的症状是面部感觉异常（72.2%）。50%的患者出现了眼球固定。7例（38.8%）患者出现腭部坏死。值得注意的是，5例（27.7%）患者出现了面瘫。另一个显著的临床表现是海绵窦血栓形成，7例患者出现此情况。我们还有2例颈动脉闭塞病例。不幸的是，3例患者死亡。
鼻脑型毛霉菌病是新冠病毒病患者尤其是有基础疾病患者最重要的并发症之一。似乎毛霉菌病恰当管理的关键在于早期诊断和及时干预，这可以让患者有更多生存机会。
