Treating patients with deep mycoses of the maxillofacial region against a COVID-19 background

Abstract

BACKGROUND: Complications characterized by necrosis of the nasal mucosa and the hard palate, as well as the middle and lower nasal concha with exposure of the alveolar process, destruction of the posterior wall of the maxillary sinus and the bottom of the orbit caused by a fungal infection were noted during the COVID-19 pandemic. By January 2022, such cases had been documented in 18 countries worldwide. The main predisposing factors for this condition are diabetes mellitus and inadequate use of corticosteroids. Rhinocerebral mucormycosis or zygomycosis is a rare disease caused by filamentous fungi affecting the nose, paranasal sinuses, and brain.
 AIM: To present the treatment strategy for patients with deep mycoses of the maxillofacial region against a background of transferred COVID-19 in the State Clinical Hospital named after F.I. Inozemtsev DZM.
 MATERIAL AND METHODS: Fifteen patients with a cerebral form of mucormycosis of the maxillofacial region arose against a background of a new coronavirus infection associated with SARS-CoV-2.
 RESULTS: The study shows the importance of timely initiation of radical surgical treatment for the rhinocerebral form of mucormycosis in the maxillofacial region, which arose against the background of SARS-CoV-2, to prevent the spread of osteomyelitic foci in bone tissue.
 CONCLUSION: Early diagnosis of mucormycosis, timely treatment with antipsychotic medications and surgical intervention, control of the level of glycemia, and reasonable use of corticosteroids prevented the development of complications.