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. 2022 Mar;74(1):103-107.
doi: 10.1007/s12070-021-02807-2. Epub 2021 Aug 15.

Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients

Esha J Desai  1 , Achal Pandya  1 , Ila Upadhya  1 , Trupal Patel  1 , Sourav Banerjee  1 , Vaishali Jain  1
Affiliations

Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients

Esha J Desai et al. Indian J Otolaryngol Head Neck Surg. 2022 Mar.

Abstract

COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral presentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis.

Keywords: COVID 19; Fungal rhinosinusitis; Mucormycosis; Rhino orbital.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of patients according to chief complaints
Fig. 2
Fig. 2
Distribution of patients according to vision
Fig. 3
Fig. 3
Distribution of patients according to medical management
See this image and copyright information in PMC

References

    1. Farnoosh G, Alishiri G, Hossseini Z, Sr, et al. Understanding the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19) based on available evidence—a narrative review. J Mil Med. 2020;22(1):1–11.
    1. International Diabetes Federation (2021) IDF sea members http://idf.org/our-network/regions-members/south-east-asia/members/94-in.... Accessed 27 June 2021
    1. Bouchara J, Oumeziane N, Lissitzky J, et al. Attachment of spores of the human pathogenic fungus Rhizopus oryzae to extracellular matrix components. Eur J Cell Biol. 1996;70(1):76–83. - PubMed
    1. Pl W, Dhillon R, Cordey A, et al. A national strategy to diagnose COVID-19 associated invasive fungal disease in the ICU. Clin Infect Dis. 2020 doi: 10.1093/cid/ciaa1298. - DOI - PMC - PubMed
    1. Sharma S, Grover M, Bhargava S, et al. Post coronavirus disease mucormycosis: a deadly addition to the pandemic spectrum. J Laryngol Otol. 2021;135(5):442–447. doi: 10.1017/S0022215121000992. - DOI - PMC - PubMed

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