COVID-19 is associated with a significant incidence of secondary infections, both bacterial and fungal immune dysregulation. Additionally, the widespread use of steroids, monoclonal antibodies, broad spectrum antibiotics as part of the armamentarium against COVID-19 may lead to the development or exacerbation of pre-existing fungal diseases. As the infection spreads, it can manifest as headaches, proptosis, ophthalmoplegia, acute vision loss, and multiple cranial nerve palsies. Mucormycosis is a rare life threatening opportunistic fungal infection caused by fungi of Mucorales order belonging to the phycomycetes class. Rhino-orbital mucormycosis usually develops in the patients with diabetes, prolonged corticosteroid use, hematological malignancies, chronic renal failure, and other immunocompromised states.
Rhino-orbital infection begins when fungal spores are inhaled and invade the nasal mucosa and sinusitis develops as the fungus spreads to the paranasal sinuses. Orbital involvement occurs when the infection invades the orbital wall from the paranasal sinuses. Symptoms may include pain, chemosis, vision loss, ophthalmoplegia and proptosis. Ophthalmoplegia arises from infection of the muscles and orbital space or when the third, fourth and sixth cranial nerves are affected. Peripheral seventh cranial nerve paresis or paralysis and hypoesthesia of the face are often observed.
Here we are presenting histopathological study of 20 cases of post COVID-19 rhino-orbital fungal infection.