Perineural spread of rhino-orbito-cerebral mucormycosis in post-Covid-19 patients-Description of this rare pathwayin the rural population of southern Rajasthan

Abstract

Various opportunistic infections were found to be more common in patients with a history of Covid-19 infection after the second wave of pandemic. The rural and tribal population was severly hit due to quack practices, lack of health care, and knowledge. Clinical features range from non-invasive sinusitis to aggressive invasive form in immunocompetent hosts. Rhino-orbito-cerebral mucormycosis (RCOM) is a very infrequent but lethal fungal infection, usually affecting diabetic patients (Ketoacidosis state). It has characteristic patterns of spread, i.e., continuous, direct spread or via vascular invasion, while perineural spread being the least common pathway of invasion. We report nine cases of invasive fungal infection with an symptomatic perineural spread in this study.