What is the role of imaging studies in the workup of rhinocerebral mucormycosis (zygomycosis)?

Updated: Jul 06, 2021
  • Author: Avnish Sandhu, DO; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Plain films may show sinus involvement with mucosal thickening, air-fluid levels, and/or bony erosions. [58]

Head and facial CT imaging should be used as the initial investigation in rhinocerebral infections. CT scans may show sinusitis of the ethmoid and sphenoid sinuses, as well as orbital and intracranial extension. As the disease progresses, bony erosion may occur and the infection may spread into the brain or orbits. In addition, because mucormycosis organisms have a predilection for vascular involvement, thromboses of the cavernous sinus or internal carotid artery may occur. [73] All of the areas of involvement must be delineated in order to plan the extent of surgical debridement.

Magnetic resonance imaging (MRI) of the facial sinuses and brain is superior to a CT scan in assessing the degree of tissue invasion and need for ongoing surgery.

Rhino-orbital-cerebral mucormycosis in a patient with SARS-CoV-2 infection. Courtesy of Dr Sujata Rege.

Rhino-orbital-cerebral mucormycosis in a patient w Rhino-orbital-cerebral mucormycosis in a patient with SARS-CoV-2 infection. Courtesy of Dr Sujata Rege.

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