Clinical and radiographic features of COVID-19 associated rhino-orbito-cerebral Mucormycosis: a brief review of litterature

Mucormycosis, also known as "black fungi", is a rare opportunistic fungal infection. One of its frequently life-threating disease manifestations is rhino-orbito-cerebral mucormycosis (ROCM). Since the outbreak of COVID-19 disease, this infection has been a global issue for the past two years. The aim of this study is to review recent literature presenting the clinical and radiographic features of this disease. PubMed, MEDLINE, and Google Scholar were searched for English language publications from December 2019 to January 2022. The data search identified 720 results. 52 articles were selected based on selected keywords. The results of this study indicated that due to treatment with corticosteroids in COVID associated patients (CAP) and other underlying factors such as poorly controlled hyperglycemia, they have been susceptible to Mucoromycosis. The most common clinical symptoms include but are not limited to throbbing or lancinating pain on temporal and orbital region of the affected side, often presence of intra and/or extraoral pain and swelling of jaw. The patient may have symptoms such as sinusitis and complain from dental pain. Diagnositic imagings such as Cone Beam Computed Tomography (CBCT), Computed tomography (CT), positron emission tomography (PET) scan and Magnetic resonance imaging (MRI) has been used widely in order to thoroughly assess the affected regions and commence treatment. Pansinusitis, sinus bone erosion, periorbital edema, subcutaneous gas, and hypodense cerebral areas may be visible through these imaging modalities. In conclusion, based on the severity of this new appearing infection, medical care staff should take percussion in management of COVID patients and be aware of the its early radiographic and clinical symptoms.