Invasive Fungal Rhinosinusitis in the Era of COVID-19: Is It an Emerging Association?

Invasive fungal rhinosinusitis (IFRS) typically affects immunocompromised patients. The coronavirus disease 2019 (COVID-19) pandemic may be associated with rare opportunistic fungal infections, probably as a result of immune dysregulation. The COVID-19 infection is characterized by low levels of CD4+T and CD8+T cells which could increase the risk of co-infections from Mucor or Aspergillus species. An invasive fungal infection should be suspected in patients who have recently recovered from COVID-19 pneumonia and present with acute destructive rhinosinusitis. There are few cases of IFRS reported in Europe during the pandemic of COVID-19. We describe the case of a 67-year-old patient with diabetes who received corticosteroids during the treatment for COVID-19 infection and was readmitted a few days later for radiologically and clinically suggested IFRS. Aspergillus niger was identified, and the patient received pharmacological and surgical treatment.