Mycological profile of fungi associated with rhino-orbital mycosis in post-COVID-19 patients

Swati Mudshingkar, Sachin Deorukhkar1, Jaishree Petkar, Chetana Joshi


Rhino-orbital mycosis is devastating fungal infection with high mortality and morbidity despite of recent advances in its diagnosis and treatment. It is caused by filamentous fungi of Mucorales order of the class of Zygomycetes. Rising number of cases presenting with fungal rhino-sinusitis with or without orbital involvement in patients recovered from coronavirus disease 2019 (COVID-19) infection was observed. Hence, present study was undertaken at a tertiary care hospital to know the mycological profile of fungi associated with these infections. Various clinical samples like deep nasal swabs, tissue from nasal cavity, nasal sinuses and orbital cavity were processed to isolate and identify fungi from suspected mucormycosis patients with standard mycological processes. Total 480 specimens from 226 patients suspected of mucormycosis were received in microbiology department of a tertiary care hospital, over 3 months period from April to June 2021. Rhino-orbital mycosis predominantly affected males and population over 50 years of age. Overall KOH positivity rate was 22.2% and culture positivity rate was 27.7% which was highest for tissue samples followed by deep nasal swabs. Most common isolate was Rhizopus spp. (51%) followed by Mucor (22%), Aspergillus (13%) and Rhizomucor (5%). Mixed infections with Mucor and Aspergillus were seen in 4% patients. Mucormycosis was observed in majority of post-COVID-19 patients and patients with high blood sugar. The majority of patients (64.1%) were suspected to have nasal involvement. Early diagnosis and prompt treatment play pivotal role in cases of mucormycosis. One should be vigilant to diagnose rhino-orbital mycosis as it is dreaded complication.


Rhino-orbital mycosis; COVID-19; Rhizopus; Corticosteroids; Diabetes

Full Text:

Supplementary files


Camara-Lemarroy CR, González-Moreno EI, Rodríguez-Gutiérrez R, Rendón-Ramírez EJ, Ayala-Cortés AS, Fraga-Hernández ML, et al. Clinical features and outcome of mucormycosis. Interdiscip Perspect Infect Dis. 2014; 2014:562610.

Chander J. Textbook of medical mycology: JP Medical Ltd; 2017.

Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J, Jr., Ibrahim AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis. 2009; 48(12):1743-51.

Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab Syndr. 2021; 15(4):102146.

Soman R, Sunavala A. Post COVID-19 Mucormycosis - from the Frying Pan into the Fire. J Assoc Physicians India. 2021; 69(1):13-4.

Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiology and Diagnosis of Mucormycosis: An Update. J Fungi (Basel). 2020; 6(4):265.

Bala K, Chander J, Handa U, Punia RS, Attri AK. A prospective study of mucormycosis in north India: experience from a tertiary care hospital. Med Mycol. 2015; 53(3):248-57.

Kamath S, Kumar M, Sarkar N, Ahmed T, Sunder A. Study of Profile of Mucormycosis During the Second Wave of COVID-19 in a Tertiary Care Hospital. Cureus. 2022; 14(1):e21054.

Zayet S, Zaghdoudi A, Ammari L, Kilani B, Tiouiri Benaissa H. Cerebro-rhino-orbital mucormycosis and aspergillosis coinfection in a patient with diabetes mellitus: A case report. IDCases. 2021; 23:e01022.

Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012; 54 Suppl 1:S23-34.

Hoenigl M, Seidel D, Carvalho A, Rudramurthy SM, Arastehfar A, Gangneux JP, et al. The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries. Lancet Microbe. 2022; 3(7):e543-e52.

Monika P, Chandraprabha MN. Risks of mucormycosis in the current Covid-19 pandemic: a clinical challenge in both immunocompromised and immunocompetent patients. Mol Biol Rep. 2022; 49(6):4977-88.

Tissopi S, Shikhare V, Ramteerthakar M, Joshi PA, Kulkarni VA. Study of rise in cases of mucormycosis during covid-19 pandemic. IP Int J Med Microbiol Trop Dis. 2023; 8(1):55-8.


  • There are currently no refbacks.

Copyright (c) 2023 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.