ARRAY OF MAGNETIC RESONANCE IMAGING FINDINGS IN POST-COVID MUCORMYCOSIS.

Abstract

Background: ROCM is a rare but extremely fatal fungal infection targeting immunocompromised individuals. There was a surge in cases in the past 2 years amongst the patients recovered from moderate to severe COVID-19 infection. Imaging is essential for early clinical recognition of this potentially fatal disease so that timely management can be done. We Methods: conducted a cross-sectional observational study with 30 COVID 19 patients suspected of having ROCM for a period of 2 months. MRI evaluation was done using conventional sequences , TOF MR Angiography and follow up imaging was done whenever possible The infection was predominantly bilat . Results: eral in 22 patients(74%) with unilateral involvement seen in 8 cases (26%) .Staging was done in preoperative patients(15 patients) with Stage 1 disease seen in 2 cases (10%), Stage 2 disease seen in 5 cases (25%) and stage 3 disease seen in 8 cases( 40%). Cavernous sinus thrombosis was seen in 8 cases (26%), ICA thrombosis in 3 cases (10%) ,CCA thrombosis in 2 cases(10%), Optic neuritis in 8 cases (26%) , ICA infarct in 5 cases (10%), involvement of pituitary gland in 1 case (3 %), intracranial focal cerebritis in 5 cases (16%) and pachymeningitis in 5 cases (16%). Black turbinate and guitar pick signs were observed. Patients underwent endoscopic or open debridement under GA. with Orbital exenteration, ethmoidectomy and medial maxillectomy. Conclusion: ROCM is thus an emerging rapidly disseminating fungal infection aficting the COVID recovered population. Aggressive debridement, systemic antifungal therapy, and control of underlying co-morbid factors is the mainstay of therapy. Radiologists play a signicant role in it's early diagnosis, evaluation of extent, thus aiding in better and faster management.