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VOLUME 15 , ISSUE 2 ( May-August, 2024 ) > List of Articles

RESEARCH ARTICLE

Prospective Longitudinal Study on COVID-19 Associated Mucormycosis: Our Experience

Shilpa MJ, Manjula BV, Brinda A Poojari, Amitha A Asharaf, Vaishnavi R, Vidya SKM, Badari DHC, Anita M Thomas

Keywords : COVID-19 associated mucormycosis, Endoscopic debridement, Maxillectomy, Mucormycosis, Otitis media with effusion, Sinusitis

Citation Information : MJ S, BV M, Poojari BA, Asharaf AA, R V, SKM V, DHC B, Thomas AM. Prospective Longitudinal Study on COVID-19 Associated Mucormycosis: Our Experience. Clin Rhinol An Int J 2024; 15 (2):58-62.

DOI: 10.5005/jp-journals-10013-1403

License: CC BY-NC 4.0

Published Online: 20-02-2025

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


Abstract

Introduction: Mucormycosis, also known as zygomycosis, is a serious fungal infection caused by a group of fungi known as Mucorales. In 2021–2022, there had been a significant increase in the incidence of COVID-19 associated mucormycosis (CAM) cases in India, especially among patients with comorbidities such as uncontrolled diabetes, prolonged intensive care unit (ICU) stay, and immunosuppression. Materials and methods: Prospective longitudinal study was carried out in the Department of ENT, Bangalore Baptist hospital from a period of April 2021 to December 2022 where 39 patients diagnosed with mucormycosis by mycological/histological/radiological diagnosis were included and who were followed up to 18–20 months. Results: Out of 39 patients, 13 were female and 26 were male (F: M ratio; 1:2). Their mean age was 51.56 years (range: 28–78 years). Patients 37 out of 39 were fit to undergo endoscopic surgical debridement, out of which 4 patients underwent orbital exenteration. During follow-up period, 23 patients underwent revision endoscopic nasal debridements, 9 underwent unilateral maxillectomy and 6 patients underwent bilateral maxillectomy. Twelve patients had lower motor neuron (LMN) facial nerve palsy, among whom 5 have recovered. Four patients had severe otitis media with conductive hearing loss who underwent myringotomy and grommet insertion. Only one patient had sudden sensorineural hearing loss (SSNHL). Conclusion: Mucormycosis remains a serious fungal infection that requires heightened awareness and a multidisciplinary approach for optimal management. In our experience, CAM had a good prognosis in spite of inadequate medical management due to non-availability of antifungal medication at the time CAM surged. A meta-analysis of all studies published in the last 3 years may help us understand CAM better and guide us regarding management protocols in the future.


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