Kavita Anand Dhabarde1, Pallavi Madhusudan Doble2, Nehali Sureshchandra Pant3, Nisha Vilas Rahul4
BACKGROUND
Mucormycosis is a potentially lethal angioinvasive fungal infection. Increasing
incidence of rhino-orbital-cerebral mucormycosis in setting of corona virus
disease-19 (COVID-19) during second wave in India and elsewhere has become a
matter of immediate concern. This study was done to assess the clinical findings
and treatment outcomes of rhino-orbital-cerebral-mucormycosis presenting to a
tertiary care center in central India.
METHODS
This is a longitudinal study. We observed 38 COVID-19 associated mucormycosis
cases. Their demographic data, clinical manifestations, underlying systemic
conditions, microbiological and radiological reports, medical treatments and
surgical interventions were recorded and analysed.
RESULTS
Common ocular presenting features were ophthalmoplegia (68 %), proptosis (44
%), periorbital swelling (13 %), diminution of vision (37 %), central retinal arterial
occlusion (2.5 %), optic atrophy (2.5 %). Visual acuity at 1 month after surgery
was compared with that at presentation and was found unchanged in 27 patients,
improved in 3 patients and deteriorated in 6 patients. Functional outcome was
evaluated in terms of ocular movements, and it was found that ocular movements
were same as presentation in 30 patients, improved in 3 patients and deteriorated
in 3 patients at follow up one month after surgery. Radiological outcome was
evaluated, and it was found that residual disease was present in 4 patients and
absent in 32 patients. Mortality was found in 2 patients at 1 month follow-up
period.
CONCLUSIONS
Early diagnosis, blood sugar levels control, urgent systemic antifungal therapy and
sinus debridement surgery are lifesaving in cases of COVID-19 associated
mucormycosis.
