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Objective: To study the COVID-19 associated mucormycosis in the head and neck region of the patients along with patient details, clinical manifestations and management.
Materials and Methods: This is a descriptive and retrospective study of COVID-19 associated mucormycosis (CAM) carried out at a postgraduate teaching hospital. This study was conducted between March 2020 to April 2021. A patient profile such as age, sex, comorbidities, clinical presentations, diagnosis and treatment of the CAM were analyzed.
Results: There were 11 patients of CAM were enrolled in this study. There were eight male and three female patients, aged from 3 years to 72 years. Out of the 11 patients, 8 were diabetic (72.72%). Three patients (27.27%) were taking prolonged systemic steroids with a long hospital ICU stay. One child (9.09%) was under chemotherapy for acute leukemia. The common clinical symptoms were facial swelling, facial pain, nasal block and nasal discharge. The diagnosis was confirmed by histological examination and fungal culture with Sabouraud dextrose agar (SDA) showing Rhizopus oryzae. All were treated with endoscopic surgical debridement and amphotericin B. One case died because of cerebral involvement.
Conclusion: Early diagnosis and prompt treatment for CAM are required. Aggressive endoscopic surgical debridement for local control and appropriate systemic antifungal treatment will help to improve the prognosis and survival of the patients.
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2. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species severe acute respiratory syndrome related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020;5: 536-44.
3. Swain SK, Jena PP. Clinical implications and future perspective of COVID-19 pandemic-a review. Int J Adv Med 2021;8(2):334-40.
4. Moura DT, McCarty TR, Ribeiro IB, Funari MP, Oliveira PV, Miranda Neto AA, et al. Diagnostic characteristics of serological-based COVID-19 testing: a systematic review and meta-analysis. Clinics 2020;75: e2212.
5. Swain SK, Das S, Padhy RN. Performing tracheostomy in intensive care unit-A challenge during COVID-19 pandemic. Siriraj Medical Journal2020 ;72(5):436-42.
6. Martínez-López R: Ecología de los hongos patógenos para el hombre. Rev Mex Mic 2005; 21:85-92.
7. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798): 270-3.
8. Velavan TP, Meyer CG. The COVID‐19 epidemic. Tropical medicine & international health. 2020;25(3):278-80.
9. Broughton JP, Deng X, Yu G, Fasching CL, Servellita V, Singh J, et al. CRISPR–Cas12-based detection of SARS-CoV-2. Nature biotechnology 2020;38(7):870-4.
10. Swain SK, Acharya S, Sahajan N. Otorhinolaryngological manifestations in COVID-19 infections: An early indicator for isolating the positive cases. J Sci Soc 2020 ;47(2):63-8.
11. Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 2020; 185:599-606.
12. Swain SK, Behera IC, Mohanty JN. Mucormycosis in head-and-neck region–Our experiences at a tertiary care teaching hospital of Eastern India. Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery 2019;3(2):58-62.
13. Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DC, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clinical Microbiology and Infection 2019;25(1):26-34.
14. Serris A, Danion F, Lanternier F. Disease entities in mucormycosis. J Fungi. 2019;5(1): 23.
15. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine 2020;8(5):475-81.
16. Tsagkovits A, Ioannidis D, Rokade A. The microscope drape method to reduce aerosolisation during endoscopic sinus and skull base surgery in the COVID era. How i do it. Eur Arch Otorhinolaryngol 2021; 278(2):573-6.
17. Anders UM, Taylor EJ, Martel JR, Martel JB. Acute orbital apex syndrome and rhino-orbito-cerebral mucormycosis. Int Med Case Rep J2015; 8:93-6.
18. Kermani W, Bouttay R, Belcadhi M, Zaghouani H, Ben Ali M, Abdelke´fi M. ENT mucormycosis. Report of 4 cases. Eur Ann Otorhinolaryngol Head Neck Dis2016; 133(2):83-6.
19. Swain SK, Sahu MC, Banerjee A. Non-sinonasal isolated facio-orbital mucormycosis–a case report. Journal de mycologie medicale 2018;28(3):538-41.
20. Sen M, Honavar SG, Sharma N, Sachdev MS. COVID-19 and Eye: A Review of Ophthalmic Manifestations of COVID-19. Indian Journal of Ophthalmology2021;69(3):488-509.
21. Swain SK, Sahu MC, Baisakh MR. Mucormycosis of the Head and Neck. Apollo Medicine 2018;15(1):6-10.
22. Spellberg B, Edwards J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005;18(3):5.
23. Gupta N, Soneja M. Amphotericin-induced pancytopenia in a patient with rhino-orbital mucormycosis. Postgraduate medical journal 2020;96(1139):572-.
24. Salmanton-García J, Seidel D, Koehler P, Mellinghoff SC, Herbrecht R, Klimko N, et al. Matched-paired analysis of patients treated for invasive mucormycosis: standard treatment versus posaconazole new formulations (MoveOn). Journal of Antimicrobial Chemotherapy 2019;74(11):3315-27.
25. Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis 2008; 47:503-9.
26. Swain SK, Lenka S, Das SR. Rhino-orbital Mucormycosis-A Dreaded Clinical Entity. Int J Cur Res Rev 2020;12(24):197-203.