Craniofacial Involvement of Mucormycosis: A Single-Center Experience of 57 Cases From Shiraz, Iran.

Abstract

Background: The incidence of mucormycosis surged significantly during the COVID-19 pandemic, particularly among patients with diabetes mellitus (DM), a history of corticosteroid use, or immunosuppression. In Iran, the heightened prevalence of this opportunistic fungal infection underscored the critical importance of timely and comprehensive treatment, encompassing both medical and surgical approaches. Methods and Material: This article aims to analyze the characteristics, clinical presentations, and treatment regimens of mucormycosis patients in Iran. Data from 57 patients referred to Shiraz University of Medical Sciences, all with confirmed pathological cultures, were evaluated. Results: Among these patients, 74% had pre-existing DM, and the most common symptom was periorbital edema (46%), followed by decreased visual acuity (28%). Amphotericin B was administered to 93% of the patients, while 75% received posaconazole. Surgical intervention was performed in 86% of the cases, primarily through functional endoscopic sinus surgery (FESS) (61%). Despite these efforts, the overall mortality rate was 26%. Conclusion: Mucormycosis emerged as a serious complication of COVID-19 in Iran. Therefore, clinicians should include it in the differential diagnosis, particularly for patients with comorbidities or a history of antibiotic or corticosteroid use, and promptly initiate antifungal treatment and surgical intervention during potential future outbreaks.