Correlation of Interleukin-6 Levels With Disease Severity in Rhino-Orbito-Cerebral Mucormycosis: A Prospective Study

Rhino-orbito-cerebral mucormycosis (ROCM) shows elevated levels of the pro-inflammatory biochemical marker interleukin-6 (IL-6) compared with healthy subjects, and this increase is significantly correlated with morbidity and disease outcome. Surgical debridement has been shown to provide significant protection against mortality in patients with ROCM. This study aimed to identify serum IL-6 levels in patients with sino-nasal mucormycosis with or without orbital/cerebral involvement, both before and after operative interventions, and to explore their possible role in disease severity.

A single-centre prospective cohort study was conducted from June 2021 to December 2022. A total of 40 patients met the inclusion and exclusion criteria. Surgical debridement combined with antifungal therapy was performed as part of the management protocol. Pre-operative and post-operative IL-6 levels were assessed, with post-operative measurement performed on day 7. Patients were further subcategorised into three groups according to radiological extent, and separate analyses were conducted for these subgroups.

Among the 40 patients, 21 (52.5%) had sinus involvement, 12 (30%) had sinus with orbital involvement, and 7 (17.5%) had sinus with orbital and cerebral involvement. Pre-operative IL-6 levels were significantly correlated with disease extent (p<0.001). In addition, there was a significant reduction between pre-operative and post-operative IL-6 levels (p<0.001).

The study indicates that IL-6 levels are correlated with disease severity. This marker may therefore serve as a valuable tool for pre-operative counselling, prognosis prediction, and guiding future treatment outcomes.