Perineural Spread in COVID-Associated Rhino-Orbito-Cerebral Mucormycosis: A Single Tertiary Care Center Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Infection with rhino-orbito-cerebral mucormycosis (ROCM) has increased in the coronavirus disease (COVID) era, especially in diabetic patients. Rapid extension from the nose and paranasal sinuses to the orbit and brain is noted by osseous erosion, vascular invasion, and infrequently documented perineural spread. OBJECTIVE: To determine the incidence of perineural spread in ROCM cases and evaluate the common neural pathways involved, which help in prognosticating and triaging patients. METHODS AND MATERIALS: We evaluated demographic, clinical, and radiological findings of 270 patients of histopathologically diagnosed ROCM. Imaging signs were used along cranial nerves for diagnosing perineural spread on magnetic resonance imaging (MRI). RESULTS: The perineural spread was observed in 30.4% patients. The most common nerves involved are the infra-orbital (20%), optic (19.2%), and maxillary (16.2%) nerves. Ischemic neuropathy was noted in 13.3% patients, predominantly along the optic nerve. CONCLUSION: We documented a substantial incidence of perineural spread and common nerves involved in ROCM cases, which has not been previously described in the literature. Perineural spread determines the true extent of disease spread which can bring about better management in this rapidly fatal infection.
Source: Neurology India
Authors: Parul Gupta, Ankita Gupta, Meenu Bagarhatta, Rajkumar Yadav, Sunil Jakhar, Kuldeep Mendiratta
Institution: SMS Medical College
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7119546743