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
Abstract :
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.
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.
