Clinical anatomical characteristics of patients with rhino-orbit-cerebral mucormycosis

Abstract

Background: postponed coronavirus infection (COVID-19), accompanied by an immunosuppressive state and associated with the risk of secondary diseases such as mucormycosis. Diabetes mellitus is an independent risk factor for both severe COVID-19 and mucormycosis.

Aims: our aim was to experience the diagnosis and treatment of rhino-orbitocerebral mucormycosis in post-COVID-19 patients.

Materials and methods: A single-center, observational, non-randomized, cohort comparative study was conducted. We assessed the clinical features, risk factors, diagnosis and outcomes of mucormycosis among recovered COVID-19 patients with hospitalisation in the otorhinolaryngology department of the Samara State Medical University Clinics, Samara, from September - December 2021. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Materials for microbiological and histopathological examination were taken from all examined patients intraoperatively.

Results: the data of the anamnesis, the course of the disease, radiodiagnosis, histopathological and microbiological methods of 15 patients with rhinoorbitocerebral mucormycosis were analyzed, the treatment was carried out according to the recommendations of the European Confederation of Medical Mycology and included the removal of necrotic tissues and etiotropic antifungal therapy (amphotericin B).

Conclusions: the effectiveness of disease management directly depends on the early initiation of etiotropic treatment, while the role of complex radiological diagnostics, histopathological and microbiological methods is important for early confirmation of the fungal etiology of the disease.

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About the authors

Alexander V. Kolsanov

Samara State Medical University

Email: avkolsanov@mail.ru
ORCID iD: 0000-0002-4144-7090
SPIN-code: 2028-6609

MD, PhD, Professor

89 Chapayevskaya St., Samara, Russia, 443099

Pavel M. Zelter

Samara State Medical University

Email: pzelter@mail.ru
ORCID iD: 0000-0003-1346-5942
SPIN-code: 3678-3932

MD, PhD

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Olesya V. Zeleva

Samara State Medical University

Email: olesyalorik@gmail.com
ORCID iD: 0000-0003-0143-4655
SPIN-code: 8139-1391

заведующая оториноларингологическим отделением Клиник ФГБОУ ВО СамГМУ Минзрава России, врач-оториноларинголог

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Olga V. Ivanova

Samara State Medical University

Email: o.v.ivanova@samsmu.ru
ORCID iD: 0000-0002-4729-6203
SPIN-code: 8806-7177

MD, PhD

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Artem V. Lyamin

Samara State Medical University

Email: a.v.lyamin@samsmu.ru
ORCID iD: 0000-0002-5905-1895
SPIN-code: 6607-8990
Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Egor A. Sidorov

Samara State Medical University

Email: egors9494@yandex.ru
ORCID iD: 0000-0002-2850-8768

врач-рентгенолог рентгенологического отделения Клиник ФГБОУ ВО СамГМУ Минзрава России

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Tatiana Yu. Vladimirova

Samara State Medical University

Email: vladimirovalor@yandex.ru
ORCID iD: 0000-0003-1221-5589
SPIN-code: 6725-4931

MD, PhD, Associate Professor

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Andrey V. Kozlov

Samara State Medical University

Email: a.v.kozlov2@samsmu.ru
ORCID iD: 0000-0001-9384-6854
SPIN-code: 6871-1845

врач-бактериолог клинико-диагностической лаборатории Клиник ФГБОУ ВО СамГМУ Минзрава России

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

Yulia Pyshkina

Samara State Medical University

Author for correspondence.
Email: yu.pyshkina@yandex.ru
ORCID iD: 0000-0002-7241-6828
SPIN-code: 4225-1020

Cand. Sci. (Med.), Assoc. Prof., Chair of Radiology and Radiation Therapy Samara State Medical University.

Russian Federation, 89 Chapayevskaya St., Samara, Russia, 443099

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