Septal Necrosis as Primary Presentation for Mucormycosis in Covid-19 Era

Document Type : Short communication

Authors

1 Lecturer of Otorhinolaryngology, Zagazig University, faculty of medicine, Egypt

2 Professor of Otorhinolaryngology, Zagazig University, faculty of medicine, Egypt

3 ORL-HNS fellow Zagazig University hospitals, faculty of medicine, Egypt

Abstract

Objectives: To report unusual presentation of sinonasal mucormycosis, To emphasize on importance of MRI sequences in dealing with mucormycosis cases.
Patients and Methods: We reported a case with persistent rhinological symptoms after Covid-19 recovery, presented endoscopically with necrotic eschar/crust on nasal septum with apparently normal lateral nasal mucosa. MRI T2 fat suppression revealed inflammatory process within RT pterygopalatine / infratemporal fossa territory. Endoscopic sinus surgery was done for debridement of necrotic septal nasal mucosa, exploration of RT PPF / ITF shows pus emerging from it with necrosis of posterior feeding vessel of the nose "SPA". Nasal septum is characterized by double vascularity from both side , but sudden interruption from one side could not be compensated from healthy side leading to necrosis.
Conclusion: Any persistent rhinological symptoms after covid-19 infection with necrotic eschar anywhere within rhino-orbital territory should be considered as mucormycosis till prove otherwise.

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