Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T19:01:26.608Z Has data issue: false hasContentIssue false

Coronavirus disease 2019 associated mucormycosis meandering its way into the orbit: a pictorial review

Published online by Cambridge University Press:  15 September 2021

T Khullar
Affiliation:
Department of Radio-diagnosis, Maulana Azad Medical College, New Delhi, India
J Kumar*
Affiliation:
Department of Radio-diagnosis, Maulana Azad Medical College, New Delhi, India
D Sindhu
Affiliation:
Department of Radio-diagnosis, Maulana Azad Medical College, New Delhi, India
A Garg
Affiliation:
Department of Radio-diagnosis, Maulana Azad Medical College, New Delhi, India
R Meher
Affiliation:
Department of Otorhinolaryngology (ENT), Maulana Azad Medical College, New Delhi, India
R Goel
Affiliation:
Department of Ophthalmology, Maulana Azad Medical College, New Delhi, India
*
Author for correspondence: Dr Jyoti Kumar, Department of Radio-diagnosis, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi110 002, India E-mail: [email protected]

Abstract

Background

There has been a recent deluge of coronavirus disease 2019 associated mucormycosis in our country. It affects the paranasal sinuses; however, it has a rapid extrasinus progression (the orbit being most common), which can be fatal if not detected early. It may meander into the orbit through various foramina without frank bone destruction.

Methods

This paper reviews the various gateways of the spread of coronavirus disease 2019 associated mucormycosis to the orbit, even before advent of bone destruction or ocular symptoms. Plausible pathways of invasion and subtle imaging findings are depicted, to enable an early diagnosis.

Results

Relevant anatomy and imaging examples have been illustrated to familiarise the surgeons with various routes of coronavirus disease 2019 associated mucormycosis spread to the orbit. Emphasis is laid on searching for subtle imaging findings for the detection of early orbital invasion.

Conclusion

Early detection and extension of coronavirus disease 2019 associated mucormycosis is facilitated by knowledge of its gateways of spread, which aids the surgeon in prognostication and planning of the surgical approach.

Type
Review Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr J Kumar takes responsibility for the integrity of the content of the paper

References

Sreshta, K, Dave, T, Varma, D, Nair, A, Bothra, N, Naik, M et al. Magnetic resonance imaging in rhino-orbital-cerebral mucormycosis. Indian J Ophthalmol 2021;69:1915–27Google ScholarPubMed
Therakathu, J, Prabhu, S, Irodi, A, Sudhakar, S, Yadav, V, Rupa, V. Imaging features of rhinocerebral mucormycosis: a study of 43 patients. Egypt J Radiol Nucl Med 2018;49:447–52CrossRefGoogle Scholar
Mukherjee, B, Raichura, N, Alam, M. Fungal infections of the orbit. Indian J Ophthalmol 2016;64:337–45CrossRefGoogle ScholarPubMed
Yohai, R, Bullock, J, Aziz, A, Markert, R. Survival factors in rhino-orbital-cerebral mucormycosis. Surv Ophthalmol 1994;39:32210.1016/S0039-6257(05)80041-4CrossRefGoogle ScholarPubMed
Johnson, T. Fungal disease of the orbit. Ophthalmol Clin North Am 2000;13:643–56CrossRefGoogle Scholar
Herrera, D, Dublin, A, Ormsby, E, Aminpour, S, Howell, L. Imaging findings of rhinocerebral mucormycosis. Skull Base 2009;19:117–25CrossRefGoogle ScholarPubMed
Abramson, E, Wilson, D, Arky, R. Rhinocerebral phycomycosis in association with diabetic ketoacidosis. Ann Intern Med 1967;66:735–42CrossRefGoogle ScholarPubMed
Rangel-Guerra, R, Martínez, H, Sáenz, C, Bosques-Padilla, F, Estrada-Bellmann, I. Rhinocerebral and systemic mucormycosis: clinical experience with 36 cases. J Neurol Sci 1996;143:1930CrossRefGoogle ScholarPubMed