Computed Tomographic features of Pulmonary Mucormycosis among Covid 19 Survivors: A Diagnostic Challenge


Authors : Rakesh Chaurasia; Ganga KC; Dipendra Pathak; Jingyun Shi; Xiwen Sun

Volume/Issue : Volume 7 - 2022, Issue 2 - February

Google Scholar : http://bitly.ws/gu88

Scribd : https://bit.ly/35r047X

DOI : https://doi.org/10.5281/zenodo.6331296

Moderate to severe corona virusinfected patients are usually managed by systemic steroids and immunosuppressant drugs, increasing the risk of opportunistic fungal infections. Pulmonary mucormycosis is a rare but fatal invasive fungal disease that mainly affects people with compromised immune systems and is associated with several diagnostic difficulties. This study sheds light on the diagnostic challenges and benefits of chest computed tomography in the early detection of mucormycosis lesions, which will help physicians and surgeons manage the disease more effectively. Methods: Our study reports a single-center experience with pulmonary mucormycosis in recovered/active COVID-19 patients. We reviewed all medical records of COVID-19 positive patients diagnosed with pulmonary mucormycosis histopathologically. Chest CT images were extracted from the Picture Archiving and Communication System (PACS) and evaluated. Results: Our study demonstrated reverse halo sign in the majority (75%) of patients during the early disease course. In addition to RHS, several other lesions like GGOs, peri-lesional halo, multiple nodular lesions, consolidative/cavitary lesions are also found during some disease stages. About 75% of patients harbor lesions exhibiting peripheral predominance with unilateral lung involvement. More than half of our study population (64%) lost their lives within a month despite aggressive medical and surgical treatment, reflecting the aggressiveness of the disease. Conclusions: This study concludes that the presence of reverse halo sign (RHS) on lung CT in Covid infected/recovered individuals was found to be a stronger indication of pulmonary mucormycosis. Hence, CT might guide the physicians to start suitable therapy earlier and enhances the outcome.

Keywords : Black fungus infection; COVID-19; CT features; Pulmonary Mucormycosis; Reverse halo sign; Zygomycetes.

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