COVID-19 Associated Mucormycosis in Head and Neck Region: Our Experiences at a Tertiary Care Teaching Hospital of Eastern India

Santosh Kumar  Swain; Pragnya Paramita  Jena; Somadatta  Das; Ankit  Gupta

doi:10.33192/Smj.2021.56

Authors

Santosh Kumar Swain Department of Otorhinolaryngology, IMS and SUM hospital, Siksha “O” Anusandhan University, K8, Kalinganagar,Bhubaneswar-751003, Odisha, India
Pragnya Paramita Jena Department of Microbiology, IMS and SUM hospital, Siksha “O” Anusandhan University, K8, Kalinganagar,Bhubaneswar-751003, Odisha, India
Somadatta Das Central Research Laboratory, IMS and SUM hospital, Siksha “O” Anusandhan University, K8, Kalinganagar,Bhubaneswar-751003, Odisha, India
Ankit Gupta Department of Microbiology, Pushpawati Singhania Hospital &Research Institute, New Delhi-110017, India

DOI:

https://doi.org/10.33192/Smj.2021.56

Keywords:

COVID-19, SARS CoV-2, COVID-19 associated mucormycosis, head and neck region, amphotericin B

Abstract

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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