Clinical Rhinology

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VOLUME 15 , ISSUE 1 ( January-April, 2024 ) > List of Articles

RESEARCH ARTICLE

COVID-19 Related Rhino-orbital-cerebral Mucormycosis in Jammu Province of Jammu and Kashmir

Monica Manhas, Amit Manhas, Aditiya Saraf, Gopika Kalsotra, Sahil Kalsotra, Inna Fayaz, Parmod Kalsotra

Keywords : Amphotericin, Mucormycosis, Rhino-orbital-cerebral Mucormycosis

Citation Information : Manhas M, Manhas A, Saraf A, Kalsotra G, Kalsotra S, Fayaz I, Kalsotra P. COVID-19 Related Rhino-orbital-cerebral Mucormycosis in Jammu Province of Jammu and Kashmir. Clin Rhinol An Int J 2024; 15 (1):25-29.

DOI: 10.5005/jp-journals-10013-1399

License: CC BY-NC 4.0

Published Online: 16-11-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aims and objectives: This study aims to present the experience of our tertiary care facility in managing Rhino-orbital-cerebral Mucormycosis within Jammu Province, Jammu and Kashmir, India, and to examine the demographic and clinical characteristics of the cases. Materials and methods: We conducted a cross-sectional descriptive study at the Department of ENT, SMGS Hospital, GMC Jammu, with institutional ethical committee approval. The study included 19 patients from Jammu Province with biopsy-confirmed mucormycosis. Comprehensive clinical data which include demographics, comorbidities, clinical features, outcomes, and radiological findings were collected. The initial treatment involved liposomal amphotericin B (5 mg/kg/day), followed by surgery based on clinical and radiological evaluations. Results: The study comprised 19 patients with biopsy-confirmed mucormycosis, with a mean age of 52.42 ± 3.77 years and a male-to-female ratio of 1.4:1. All patients (100%) had received steroids as part of their COVID-19 treatment, and all had uncontrolled diabetes mellitus (100%). Additional comorbidities included hypertension in 6 patients (31.6%), diabetic ketoacidosis in 2 patients (10.5%), and chronic kidney disease in 1 patient (5.3%). Of the 19 patients, 18 (94.7%) were initially treated with liposomal amphotericin B, followed by surgical intervention. Histopathological analysis post-surgery confirmed mucormycosis in all 18 cases (100%). Follow-up revealed a mortality rate of 31.6% (6 patients) and a recovery rate of 68.4% (13 patients). Conclusion: A multidisciplinary approach is essential, including education on the warning signs and symptoms of mucormycosis, prompt diagnostic nasal endoscopy and direct microscopy of nasal swabs, contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), and aggressive treatment with full-dose liposomal amphotericin B and appropriate surgical interventions.


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