Clinicopathological Study of Mucormycosis at Varied Sites During the COVID-19 Pandemic

Mucormycosis, also known as black fungus, is a rare but serious fungal infection caused by mucor that belongs to Zygomycotic species. Mucor is characterized by non-septate, irregularly wide hyphae with right-angle branching. Mucor can infect different systems of the body and manifest differently depending on the location of the infection, which includes pulmonary, gastrointestinal, rhino-cerebral, and cutaneous. The study aims to analyze the incidence, clinical history, and microscopic features associated with mucormycosis in the COVID-19 pandemic at our institute. This is a prospective study conducted in the Department of Pathology for three years from March 2020 to April 2022. The samples were collected from different clinical departments mostly from Surgery and Radiology. These samples were fixed in 10% formalin, processed, stained with hematoxylin and eosin (H&E) and were analysed. A total of 69 cases were included in the study. The age range was 25-80 years and male preponderance was seen with an M:F ratio of 2.6:1. Diabetes was the most common risk factor seen in 53 (77%) cases followed by post-COVID-19 status in 49 (71%) cases. The most common site was paranasal sinuses (58, 84%) followed by orbit (eight, 11%) and two (2.8%) cases each of lung and bone. Fifty (72.4%) cases showed necrosis and 10 (14.5%) cases showed granulomatous inflammation. Angioinvasion was seen in 27 (39%) cases, bony invasion was seen in 26 (37.6%) cases and perineural invasion was seen in one (1.4%) case. We had three (4.3%) cases of mixed fungal infection (mucor and Aspergillus). This study describes the clinical site of presentation and histopathological features of mucormycosis.