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Rhino-orbito-cerebral mucormycosis: an epidemic in a pandemic
Anuradha Sekaran1, Nayana Patil1, Swapnali Sabhapandit2
1Department of Pathology, AIG Hospitals, Hyderabad, Telangana, India.
IJID Regions
|June 20, 2022
Summary
Rhino-orbito-cerebral mucormycosis (ROCM) cases surged in India during the COVID-19 pandemic, particularly in diabetic patients using steroids. Prompt multidisciplinary management is crucial for survival.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pathology
Background:
- Opportunistic rhino-orbito-cerebral mucormycosis (ROCM) cases have notably increased in India.
- This surge coincided with the coronavirus disease 2019 (COVID-19) pandemic.
Purpose of the Study:
- To investigate laboratory parameters in ROCM patients.
- To analyze histopathological features of sinus mucosal biopsies and orbital specimens.
- To document clinical aspects of ROCM patients during the COVID-19 pandemic.
Main Methods:
- Retrospective analysis of 30 ROCM patients.
- Examination of sinonasal debridement and orbital exenteration specimens.
- Review of laboratory results, clinical history, and medication use during COVID-19.
Main Results:
- Most ROCM patients had diabetes mellitus with elevated glycosylated hemoglobin.
- Many patients received steroids and antibiotics for COVID-19.
- Mucor spp. were identified in necrotic tissue with vessel and nerve invasion; four deaths occurred.
Conclusions:
- ROCM is a life-threatening fungal infection requiring high suspicion and aggressive multidisciplinary management.
- Maintaining optimal glycemic control is vital for preventing ROCM.
- Judicious steroid use is essential to mitigate the collateral epidemic of ROCM.
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