COVID-19 and rhino-orbital mucormycosis – a case report

There is a constant rise in cases of rhino-orbital mucormycosis in people with Coronavirus disease 2019 (COVID-19). Generally, Mucormycosis develops in immunosuppression or debilitating diseases. In cases having head and neck involvement, the mold enters the respiratory tract with further involvement of nose and sinuses and there is consecutive progression into orbital and intracranial structures. Diabetes Mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. The clinical examination and direct smears are helpful for early diagnosis of the disease and timely intervention. For the better prevention and management of such opportunistic infections in COVID-19 patients, it is prudent to establish prophylactic treatment protocols along with rational use of corticosteroids. We here report a case of Rhino-orbital Mucormycosis infection caused by Rhizopus oryzae in a COVID-19 patient with Diabetes Mellitus.

Study of Management of Cerebrospinal Fluid Rhinorrhea

Cerebrospinal fluid (CSF) rhinorrhea is a condition where the protective fluid that surrounds the brain finds its way into the nose and sinuses, often appearing as a very watery runny nose. In this study, we are looking for clinical picture, various available investigation and treatment modalities, and their outcomes. In this study, we include 60 patients diagnosed with CSF rhinorrhea irrespective of cause. Patient having similar clinical picture but ruled out by investigation are not included. We obtain result in terms of most common causative factor, common site, and efficacy of treatment, and can decide a favorable line of management with respect to different circumstances.

Mucormycosis in COVID Times

Mucormycosis is a disease caused by the fungus of the Mucorales species. These fungi are present in the environment and are common commensals in the human body, mainly in the nose and sinuses, or respiratory tract and lungs. Rarely, in immunocompromised individuals or those who have temporary depression of immunity, these fungus manifest most commonly as rhino-cerebral mucormycosis or pulmonary mucormycosis. At rare times, the skin may also get involved. Recently ICMR has come up with guidelines for mucormycosis, in this commentary, it's our primary focal article.

Paranasal Carcinoma: A Case Series

Objective: To emphasize the importance of early diagnosis of cancer of paranasal sinus. Method: This is retrospective case series done in Liaquat National Hospital. Data were retrieved from August to October 2020. Results: Data of a total of 5 patients with sinonasal cancer was reviewed. Four patients presented with extensive disease. Three patients were male and two were female. The age of patients was between 40 and 70 years. All these five patients underwent surgery. Four patients were referred for concurrent chemoradiotherapy (CCRT) and one patient expired after surgery. Conclusion: Malignant tumors of the nose and sinuses are rare constituting 3% of head and neck malignancies. The early symptoms are relatively innocuous and are often ignored by the patient, their general practitioners and even ENT surgeons leading to a delayed diagnosis and treatment. Although paranasal tumors are rare they should be in our differential.

The nose and sinuses

This chapter describes the anatomy and function and lists the common conditions affecting the nose. The investigation, diagnosis, and medical and surgical management of rhinosinusitis with or without polyps are discussed. Complications of sinusitis are outlined, along with their modes of presentation. Common septal problems and granulomatous conditions, as well as rare malignancies, are listed.