Experience on rhino-orbital mucormycosis from a tertiary care hospital in the first wave of COVID-19: An Indian perspective.

Aseptate fungus COVID-19 Diabetes Exenteration Orbital mucormycosis

Journal

Medical journal, Armed Forces India
ISSN: 0377-1237
Titre abrégé: Med J Armed Forces India
Pays: India
ID NLM: 7602492

Informations de publication

Date de publication:
02 Apr 2022
Historique:
received: 05 12 2021
accepted: 18 01 2022
entrez: 11 4 2022
pubmed: 12 4 2022
medline: 12 4 2022
Statut: aheadofprint

Résumé

To highlight the clinical presentations and management outcomes of rhino-orbital mucormycosis during first wave of COVID-19 pandemic in North India. A retrospective observational study. 15 patients with mucormycosis (orbital disease) who presented during short span of 3 months (October-December 2020) in a tertiary-care referral institution were analysed. At presentation, 13 of 15 patients had uncontrolled diabetes. Four had history of COVID-19 infection. All patients had advanced orbital disease with sinusitis; cavernous sinus involvement was in nine and intracranial spread in three patients. Liposomal amphotericin-B was started and prompt orbital exenteration with sinus surgery was performed in 12 patients. All 12 patients survived with an average follow-up of 4.8 months. In the present series, cases with orbital spread of mucormycosis were mostly found in non-COVID uncontrolled diabetics. Exenteration was done in 80% of cases with advanced orbital disease. Prevention and early detection of infection at the stage of sino-nasal involvement might help to prevent spread and/or halt the orbital disease.

Sections du résumé

Background UNASSIGNED
To highlight the clinical presentations and management outcomes of rhino-orbital mucormycosis during first wave of COVID-19 pandemic in North India.
Methods UNASSIGNED
A retrospective observational study. 15 patients with mucormycosis (orbital disease) who presented during short span of 3 months (October-December 2020) in a tertiary-care referral institution were analysed.
Results UNASSIGNED
At presentation, 13 of 15 patients had uncontrolled diabetes. Four had history of COVID-19 infection. All patients had advanced orbital disease with sinusitis; cavernous sinus involvement was in nine and intracranial spread in three patients. Liposomal amphotericin-B was started and prompt orbital exenteration with sinus surgery was performed in 12 patients. All 12 patients survived with an average follow-up of 4.8 months.
Conclusion UNASSIGNED
In the present series, cases with orbital spread of mucormycosis were mostly found in non-COVID uncontrolled diabetics. Exenteration was done in 80% of cases with advanced orbital disease. Prevention and early detection of infection at the stage of sino-nasal involvement might help to prevent spread and/or halt the orbital disease.

Identifiants

pubmed: 35400798
doi: 10.1016/j.mjafi.2022.01.009
pii: S0377-1237(22)00009-0
pmc: PMC8975717
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

© 2022 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.

Déclaration de conflit d'intérêts

The authors have none to declare.

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Auteurs

Gunjan Saluja (G)

Senior Resident, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Anju Bhari (A)

Senior Resident, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Neelam Pushker (N)

Professor, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Sahil Agrawal (S)

Senior Research Officer, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Rachna Meel (R)

Professor, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Alok Thakar (A)

Professor (Otolaryngology), AIIMS, New Delhi, India.

Immaculata Xess (I)

Professor (Microbiology), AIIMS, New Delhi, India.

Ankur Khandelwal (A)

Senior Resident (Anaesthesia), AIIMS, New Delhi, India.

Anubhav Narwal (A)

Senior Resident (Pathology), AIIMS, New Delhi, India.

Mandeep S Bajaj (MS)

Professor, Oculoplastics, Tumor & Pediatric Ophthalmology Services, Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.

Classifications MeSH