Document Type : Review Article


1 Assistant Professor of Neurology, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Associate Professor of Otorhinolaryngology, Head and Neck Surgery, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran


Introduction: Mucormycosis is a disease that is common in patients with a history of diabetes mellitus who have recently been infected with Covid-19, and it affects the nervous system more than other systems. This study was designed with the aim of examining the symptoms and complications of the nervous system in patients with mucormycosis.
Method: Searches were conducted in PubMed, Scopus, Science Direct, and Google Scholar databases between December 2019 and the first five months of 2020. The search terms were: Covid-19, SARS-CoV-2, olfactory disorder, loss of taste, mucormycosis, neurological manifestations, diabetes mellitus, neurological disorder, eye disease, thyroid disease, and diabetes complication.
Results: In the initial search, 1259 articles were extracted, after removing the duplicates and evaluating the title and abstract, the articles with the necessary conditions to participate in the present study were selected, and general conclusions were made based on information in the various selected articles.
Conclusion: Whether the findings of this study are sufficient to increase health literacy about mucormycosis and how much this information increases health literacy concerning mucormycosis should be determined in future studies. Given that the Internet is one of the most important sources of health knowledge in our society. Providing the correct information about the contents that are discussed in virtual spaces, especially about topics of interest to people such as traditional medicine and nutrition in the control of mucormycosis disease, can improve people's ability to evaluate the correctness or incorrectness of the information in these spaces.

Graphical Abstract

Symptoms and Complications of Nervous System in Patients with Mucormycosis: A Systematic Review


Main Subjects

  • Mathieu, A. Marroni, J. Kot, Tenth European Consensus Conference on Hyperbaric Medicine: Recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med., 47 (2017) 24–32.
  • A. Cornely, S. Arikan-Akdagli, E. Dannaoui, A.H. Groll, K. Lagrou, A. Chakrabarti, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin Microbiol Infect., 3 (2014) 5–26.
  • Ahmed, , M.A. Severson , V.C. Traynelis. Role of hyperbaric oxygen therapy in the treatment of bacterial spinal osteomyelitis. J Neurosurg Spine., 10 (2009) 16–20.
  • J. Bartek, S. Skyrman, M. Nekludov, T Mathiesen, F. Lind, G. Schechtmann. Hyperbaric oxygen therapy as adjuvant treatment for hardware-related infections in neuromodulation. Stereotact Funct Neurosurg., 96 (2018) 100–7.
  • J. Bartek, A.S. Jakola, S. Skyrman, P. Förander, P. Alpkvist, G. Schechtmann, et al. Hyperbaric oxygen therapy in spontaneous brain abscess patients: A population-based comparative cohort study. Acta Neurochir (Wein)., 158 (2016) 1259–67.
  • Larsson, M. Engström, J. Uusijärvi, L. Kihlström, F. Lind, T. Mathiesen, Hyperbaric oxygen treatment of postoperative neurosurgical infections. Neurosurgery., 50 (2002) 287–95.
  • M. Haghdoost, M.K. Gol, The necessity of paying more attention to the neurological and psychological problems caused by the COVID-19 pandemic during pregnancy. International Journal of Women’s Health and Reproduction Sciences., 3 (2020) 243-44.
  • J. Ferguson, T.G. Mitchell, R. Moon, E.M. Camporesi, J. Farmer, Adjunctive hyperbaric oxygen for treatment of rhinocerebral mucormycosis. Rev Infect Dis., 10 (1988) 551–9.
  • SM Haghdoost, S Mousavi, MK Gol, M. Montazer. Frequency of Chlamydia trachomatis Infection in Spontaneous Abortion of Infertile Women During First Pregnancy Referred to Tabriz University of Medical Sciences by Nested PCR Method in 2015. International Journal of Women’s Health and Reproduction Sciences., 7 (2019) 526-30.
  • M. Tibbels, J.S. Edelsberg, Hyperbaric-oxygen therapy. N Engl J Med., 334 (1996) 1642–8.
  • Y. Memar, M. Yekani, N. Alizadeh, H.B. Baghi. Hyperbaric oxygen therapy: Antimicrobial mechanisms and clinical application for infections. Biomed Pharmacother., 109 (2019) 440–7.
  • Benkő, Z. Miklós, V.A. Ágoston, K. Ihonvien, C. Répás, R. Csépányi-Kömi, et al. Hyperbaric oxygen therapy dampens inflammatory cytokine production and does not worsen the cardiac function and oxidative state of diabetic rats. Antioxidants (Basel)., 8 (2019) 607.
  • MK Gol, F Jabarzade, V Zamanzadeh. Cultural competence among senior nursing students of medical universities in North-West Iran. J Urmia Nurs Midwifery Fac., 18 (2017) 612-19.
  • M. Ronagh, A. Panahali, A. Lotfi, P.F. Ahmadpour. Comparison of body image and life satisfaction among patients undergoing cosmetic surgery and candidates for the surgery in maxillofacial department at Imam Reza Hospital in Tabriz. Razi Journal Of Medical Sciences. 2018.
  • C. Lin, K.C. Niu, K.J. Tsai, J.R. Kuo, L.C. Wang, C.C. Chio, et al. Attenuating inflammation but stimulating both angiogenesis and neurogenesis using hyperbaric oxygen in rats with traumatic brain injury. J Trauma Acute Care Surg., 72 (2012) 650–659.
  • R. Fischer, E.J. Speckmann, C. Greiner, A. Gorji, J. Wölfer, H. Wassmann, Hyperbaric oxygen in neurosurgery. Acta Neurochir (Wien)., 151 (2009) 415–8.
  • Couch, F. Theilen, J.T. Mader, Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy. Arch Otolaryngol Head Neck Surg., 114 (1988) 791–4.
  • Motaleb, M. Mohamed, F. Mobarak, A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report. Journal of International Oral Health., 7 (2015) 68–71.
  • Bonyadi, M. Esmaeili, M. Abhari, A. Lotfi. Mutation analysis of familial GJB2-related deafness in Iranian Azeri Turkish patients. Genetic testing and molecular biomarkers., 13 (2009) 689–92.
  • Heyboer, D. Sharma, D. Santiago, N. McCulloch. Hyperbaric oxygen: Side effects defined and quantified. Adv Wound Care (New Rochelle)., 6 (2017) 210–24.
  • V. Sipsas, M.N. Gamaletsou, A. Anastasopoulou, D.P. Kontoyiannis. Therapy of mucormycosis. J Fungi (Basel)., 4 (2018) 90.
  • Spellberg, A.S. Ibrahim. Recent advances in the treatment of mucormycosis. Curr Infect Dis Rep., 12 (2010) 423–9.
  • J. Lerche, L.J. Christophersen, M. Kolpen, P.R. Nielsen, H. Trøstrup, K. Thomsen, et al. Hyperbaric oxygen therapy augments tobramycin efficacy in experimental Staphylococcus aureus endocarditis. Int J Antimicrob Agents., 50 (2017) 406–12.
  • Shahidi, A. Lotfi. Epidemiology and Clinical Findings of Oral Squamous Cell Carcinoma. Majallah-i Pizishki-i Danishgah-i ulum-i Pizishki-i Tabriz., 44 (2022) 67–71.
  • Tragiannidis, A.H. Groll. Hyperbaric oxygen therapy and other adjunctive treatments for zygomycosis. Clin Microbiol Infect., 15 (2019) 82–6.
  • Charsouei, F. Mahdavi, A.R. Nasseri. Evaluation of Three-and Five-Year Disease-Free Survival in Patients With Cervical Cancer With Spinal Cord Metastasis Under Treatment With External Radiotherapy Brachytherapy. International Journal of Women's Health and Reproduction Sciences., 10 (2022) 97–102.
  • Almannai, H. Imran, B. Estrada, A.H. Siddiqui. Successful treatment of rhino-orbital mucormycosis with posaconazole and hyperbaric oxygen therapy. Pediatr Hematol Oncol., 30 (2013) 184–6.
  • D. Mignogna, G. Fortuna, S. Leuci, D. Adamo, E. Ruoppo, M. Siano. Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature. International Journal of Infectious Diseases., 15 (2011) e533–40.
  • L García-Covarrubias, DM Barratt, R Bartlett, K Van Meter. Treatment of mucormycosis with adjunctive hyperbaric oxygen: five cases treated at the same institution and review of the literature. Rev Invest Clin., 56 (2004) 51–5.
  • V. John, G. Chamilos, D.P. Kontoyiannis. Hyperbaric oxygen as an adjunctive treatment for zygomycosis. Clin Microbiol. Infect., 11 (2015) 515–7.
  • G. Deepa, B.J. Nair, T.T. Sivakumar, A.P. Joseph. Uncommon opportunistic fungal infections of oral. J Oral Maxillofac Pathol., 18 (2014) 235–43.
  • Charsouei, M.Z. Esfahlani, A. Dorosti, R.E. Zamiri. Effects of COVID-19 pandemic on perceived stress, quality of life, and coping strategies of women with breast cancer with spinal metastasis under chemotherapy. International Journal of Women's Health and Reproduction Sciences., 9 (2021) 55–60.
  • kim, J. Fortson, H. Cook, A Fatal Outcome From Rhinocerebral Mucormycosis After Dental Extractions: A Case Report. J Oral Maxillofac Surg., 59 (2001) 693–697.
  • Fogarty, F. Regennitter, C. Viozzi. Invasive Fungal Infection of the Maxilla Following Dental Extractions in a Patient with Chronic Obstructive Pulmonary Disease. J Can Dent Assoc., 72 (2006) 149–52.
  • Bakathir, Mucormycosis of the Jaw after Dental Extractions: Two Case Reports. Sultan Qaboos Univ Med J., 6 (2006) 77–82.
  • Auluck, Maxillary necrosis by mucormycosis. A case report and literature review. Med Oral Patol Oral Cir Bucal., 12 (2007) E360–4.
  • Papadogeorgakis, E. Parara, V. Petsinis, C. Vourlakou, A case of successfully treated rhinocerebral mucormycosis: dental implications. Int J Dent., 2010 (2010) 273127.
  • A. Kumar, P. Babu, K. Prabu, P. Kumar, Mucormycosis in maxilla: Rehabilitation of facial defects using interim removable prostheses: A clinical case report. J Pharm Bioall Sci., 5 (2013) S163–5.
  • Choudhary, D. Bhargava, V. Chandavarkar, R. Sharma. Mucormycosis of maxilla. Indian J Dent Adv., 6 (2014) 1503–6.
  • Nilesh, N.A. Malik, U. Belgaumi. Mucormycosis in a healthy elderly patient presenting as oro-antral fistula: Report of a rare incidence. J Clin Exp Dent., 7 (2015) e333–6.
  • Kumar, A.K. Singh, S. Pandey, S. Singh. Rhino-maxillary osteomyelitis due to mucormycosis in an immunocompromised geriatric patient: A case report with review of treatment options. Int J Health Allied Sci., 4 (2015) 160–4.
  • S Arya, B Sharanamma, N Patil, B Anitha, S Bhateja, Basavaraj Rhino-maxillary form of mucormycosis causing sinusitis: a rare case report with review of literature. Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology., 1 (2015) 39–44.
  • M. Laihad, I. Ketut Sudiana, M. Guritno Suryokusumo, Case Report: The Diagnosis, Treatment and Outcome of a Rare Case Suspected as Mucormycosis. Pinnacle Medicine & Medical Sciences., 2 (2015) 502–5.
  • Charsouei, L. Ghaderi, H.M. Anvari, R.E Zamiri. Investigating the factors affecting the severity of neuropathic pain before and after the coronavirus infection in patients having breast cancer surgery. International Journal of Women's Health and Reproduction Sciences., 9 (2021) 190–94.
  • Musaei, The Effect of Pregnancy on the Skin, Eurasian Journal of Chemical, Medicinal and Petroleum Research, 2 (2023) 17-23. [Publisher]
  • Atashzadeh-Shoorideh, S. Parvizy, M. Hosseini, Y. Raziani, F. Mohammadipour, Developing and validating the nursing presence scale for hospitalized patients, BMC nursing, 21 (2022) 1-6
  • Raziani, L. Hasheminasab, R. Ghanei Gheshlagh, P. Dalvand, V. Baghi, M. Aslani, The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis, Scandinavian Journal of Public Health, 2022.
  • Raziani, S.H. Qadir, A.H. Hermis, A. Nazari, B. Salah Othman, S. Raziani, Pistacia atlantica as an effective remedy for diabetes: a randomised, double-blind, placebo-controlled trial, Australian Journal of Herbal and Naturopathic Medicine, 34 (2022) 118-124
  • Amin, M.R. Gavanrudi, K. Karami, Y. Raziani, P. Baharvand, The role of aromatherapy with lavender in reducing the anxiety of patients with cardiovascular diseases: A systematic review of clinical trials, Journal of Herbmed Pharmacology, 11 (2022) 182-187
  • Raziani, S. Hossein Qadir, B. Salah Othman, A. Mohammed Ahmed, The Student Voice To Improve Osce, Mosul Journal of Nursing, 10 (2022) 89-97
  • Raziani, B. Salah Othman, S. Raziani, A common but unknown disease; A case series study, Annals of Medicine and Surgery, 69 (2021) 102739
  • Alnomasy, G. Raheem Lateef Al-Awsi, Y. Raziani, A.E. Albalawi, A.D. Alanazi, M. Niazi, H. Mahmoudvand, Systematic review on medicinal plants used for the treatment of Giardia infection, Saudi Journal of Biological Sciences, 28 (2021) 5391-5402
  • Ghorbanizadeh, Y. Raziani, M. Amraei, M. Heydarian, Care and precautions in performing CT Scans in children, Journal of Pharmaceutical Negative Results, 12 (2021) 54
  • Raziani, S. Raziani, Evaluation of Mental Health of Chemotherapy-Treated Cancer Nurses, Journal of Medicinal and Chemical Sciences, 4 (2021) 351-363
  • Raziani, B. Salah Othman, Ointment therapy and prevention of cannulation-induced superficial phlebitis, Veins and Lymphatics, 10 (2021).
  • Raziani, S. Raziani, The effect of air pollution on myocardial infarction, Journal of Chemical Reviews, 3 (2021) 83-96
  • Shahkarami, M. Nazari, M. Milanifard, R. Tavakolimoghadam, A. Bahmani, Eurasian Chem. Commun., 4 (2022) 463-472. [Crossref], [Google Scholar], [Publisher]‏‏‏
  • Z. Nazardani, S.H. Nourizadeh Dehkordi A. Ghorbani, A comprehensive evaluation of the Sports Physiotherapy curriculum, Eurasian Journal of Chemical, Medicinal and Petroleum Research, 2 (2023) 10-16. [Google Scholar], [Publisher]‏‏‏
  • Ghaibi, M.R. Soltani Manesh, H. Jafari Dezfouli, F. Zarif, Z. Jafari, Z. Gilani, Comparison of Marital Satisfaction, Emotional Divorce and Religious Commitment among Nurses and Staff of Ahvaz Government Hospitals, Eurasian Journal of Chemical, Medicinal and Petroleum Research, 1 (2022) 33-39. [Google Scholar], [Publisher]‏‏‏.‎