Case Report Coinfection by Aspergillus and Mucoraceae Species in Two Cases of Acute Rhinosinusitis as a Complication of COVID-19 Payam Tabarsi , 1 Somayeh Sharifynia , 1 Mihan Pourabdollah Toutkaboni , 2 Zahra Abtahian , 1 Mohammad Rahdar , 3 Arefeh Sadat Mirahmadian , 3 and Atousa Hakamifard 3 1 Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Correspondence should be addressed to Atousa Hakamifard; atousahakamifard@sbmu.ac.ir Received 1 December 2021; Revised 28 January 2022; Accepted 19 February 2022; Published 14 March 2022 Academic Editor: Simone Cesaro Copyright © 2022 Payam Tabarsi et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute invasive fungal rhinosinusitis (AIFR) is a life-threatening infection often found in immunocompromised patients. In the COVID-19 era, reports of AIFR have emerged, with high mortality and morbidity rate. is paper presents two cases of COVID- 19 associated AIFR with the combined proven fungal etiology of Aspergillus flavus and Rhizopus arrhizus in case 1 and Aspergillus fumigatus and Rhizopus arrhizus in case 2. Both patients received liposomal amphotericin B then posaconazole combined with aggressive surgical debridement of necrotic tissues with a favorable clinical outcome. Mixed etiology AIFR can influence the outcome; hence, further studies are required upon this new threat. 1. Introduction e prevalence of invasive fungal infections (IFIs) has increased and become one of the leading causes of mor- tality and morbidity, particularly in immunosuppressed patients. Most of these infections are described in patients with diabetes mellitus, hematologic malignancies, and solid organ transplantation [1]. Bacterial coinfection in SARS- CoV-2, including Streptococcus pneumoniae, Klebsiella pneumoniae, or Haemophilus influenza, and fungal coin- fection, including Aspergillus or Mucoraceae species have become a serious concern in the management of patients with COVID-19 [2, 3]. Both of these fungal infections have been well described as complications of COVID-19, es- pecially among critically ill patients in intensive care units [4]. Herein, we report two cases of acute invasive fungal rhinosinusitis (AIFR) with combined Aspergillus and Mucoraceae species. 2. Case Presentation 2.1. Case 1. e first case was a healthy 31-year-old woman with a five-day history of fever (38.5 ° C), myalgia, and severe dyspnea (SpO 2 was 85%–room air), who referred to the emergency department. Reverse transcription-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 diagnosis. High-resolution chest CTs obtained at admission showed multifocal areas of consolidation and ground-glass opaci- fication with peripheral and basal predominance. Supportive oxygen therapy with nasal cannula and treatment with remdesivir at a dose of 200 mg on day one and 100 mg/d for five days with methylprednisolone 80 mg every 12 hours were prescribed. Methylprednisolone continued for two days and then switched to dexamethasone 4 mg/d, which continued for additional four days. e patient’s condition improved over ten days, and the patient was discharged with SpO 2 � 93%, afebrile, and improved cough. Several days after Hindawi Case Reports in Medicine Volume 2022, Article ID 8114388, 6 pages https://doi.org/10.1155/2022/8114388