Iranian Journal of Pathology

Rhinocerebral Mucormycosis Following Post-COVID-19 Infection in Iran

Document Type : Original Research

Authors

Parisa Khorasani Esmaili 1
Shahriar Dabiri 1
Tooraj Reza Mirshekari 2
Fatemeh Nabipour 3
Ayeh Shamsadini 4
Hadi Eslami 5
Mohammad Ali Damghani 6
Ali Asghar Arabi 6
Maryam Amizadeh 6
Fatemeh Fani 6
Navid Gharaei 6
Shiva Pouradeli 7

1 Department of Pathology , Pathology and Stem Cells Research Center, Afzalipour Medical School, Kerman Medical University, Kerman, Iran

2 Department of Pathology, Kerman University of Medical Sciences, Kerman, Iran

3 Department of Pathology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran

4 Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran

5 Department of Otolaryngology and Head and Neck Surgery, Kerman University of Medical Sciences, Kerman, Iran

6 Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran

7 Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran

https://doi.org/10.30699/ijp.2023.545953.2845
Abstract
Background & Objective: Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage.
Methods: In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and Facial nerve dysfunction; they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid–Schiff (PAS) staining methods to rule out mucormycosis.
Results: In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy; also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago).
Conclusion: COVID-19 infection could play a predisposing factor for many opportunistic infections, such as fungal elements); thus, the physician should be aware of the dose and day of corticosteroid therapy to prevent these infections.

Keywords

Black fungal
COVID-19
Iran
Mucormycosis
Rhinocerebral

Subjects

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Iranian Journal of Pathology
Volume 18, Issue 2
Spring 2023
Pages 116-124

  • Receive Date 24 April 2022
  • Revise Date 30 October 2022
  • Accept Date 30 November 2022

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