Skip to main content

Advertisement

Log in

Minimizing the Recurrence Rate in Covid Associated Mucormycosis: Our Experience in 500 Patients

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Mucormycosis is an aggressive, fatal fungal infection. The fungal organisms are ubiquitous and easily affect immunocompromised patients. The main aim of this article is to emphasize over the knowledge of different diagnostic methods (diagnostic nasal endoscopy, ct/ contrast mri pns + orbit + brain, Wet KOH mount), the importance of practising an aggressive surgical resection, medical treatments (liposomal amphotericin B, amphotericin gel, tablet posaconazole, nasal douching, retrorbital amphotericin injection), suction cleaning and regular follow up of the patient after surgical management. This can greatly help in minimizing the recurrence of mucormycosis even in immunocompromised patients in a population. The study performed was a prospective study conducted from April 2021 to July 2021 in which we included 500 patients who presented to the OPD & Department of ENT or Emergency Department of Maharaja Yashwantrao Hospital with complaints suggestive of mucormycosis. The patients who were surgically fit were operated. Out of the 500 patients who were diagnosed with Mucormycosis, from April 2021 to July 2021 complete cure was achieved in 456 patients( 91.2%) and only 44 patients (8.8%) have shown recurrence due to various causes (specially those who did not came for regular follow up). Rhinorbital was the most common site to be involved. In the study it was found that most of the patients which showed recurrence were male, post covid and immunocompromised. Diabetes mellitus was found to be most common among immunocompromised patients. The recurrence in patients with mucormycosis can be minimise by educating the masses regarding importance of public and personal hygiene, and multidisciplinary management with regular follow up offers a better approach to treat this life-threatening condition. The study shows the importance of clinical diagnosis, concurrent surgical treatment, medical treatment, post op care, suction cleaning and regular follow up advice. It is necessary us to take the step forward in this regard, so that in the future we will be better prepared for such type of epidemic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Panneerselvam K, Kumar MS, Karthikeyan, Mohan AM (2020) Recurrent mucormycosis—better understanding of treatment and management. J Fam Med Prim Care 9(12):6279–6281

    Article  Google Scholar 

  2. Rai S, Misra D, Misra A, Jain A, Jain P, Dhawan A (2018) Palatal mucormycosis masquerading as bacterial and fungal osteomyelitis: a rare case report. Contemp Clin Dent 9(2):309–313

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP (2012) Pathogenesis of mucormycosis. Clin Infect Dis 54(Suppl 1):S16-22

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Lim S, Bae JH, Kwon H-S, Nauck MA (2021) COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol 17(1):11–30

    Article  CAS  PubMed  Google Scholar 

  5. Tran D, Schmit B (2020) An aggressive case of mucormycosis. Cureus. 12(8):e9610

    PubMed  PubMed Central  Google Scholar 

  6. Hernández J, Buckley C (2021) Mucormycosis. StatPearls. Available from: https://www.statpearls.com/ArticleLibrary/viewarticle/25325

  7. Spellberg B, Edwards J, Ibrahim A (2005) Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 18(3):556–569

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Rammaert B, Lanternier F, Poirée S, Kania R, Lortholary O (2012) Diabetes and mucormycosis: a complex interplay. Diabetes Metab 38(3):193–204

    Article  CAS  PubMed  Google Scholar 

  9. Kontoyiannis DP, Lewis RE (2011) How I treat mucormycosis. Blood 118(5):1216–1224

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Price JC, Stevens DL (1980) Hyperbaric oxygen in the treatment of rhinocerebral mucormycosis. Laryngoscope 90(5 Pt 1):737–747

    Article  CAS  PubMed  Google Scholar 

  11. Reed C, Bryant R, Ibrahim AS, Edwards J, Filler SG, Goldberg R et al (2008) Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis 47(3):364–371

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The Authors acknowledge Dr. Sanjay Dixit, Dean & CEO of MGMMC, Indore and Dr. PS Thakur, Superintendent, MYH, Indore for providing advice and support for management of these cases.

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Indra Prakash Prajapati.

Ethics declarations

Conflict of interest

The author(s) declare none.

Ethical Approval

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation (please name) and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jain, A., Gupta, Y., Verma, J. et al. Minimizing the Recurrence Rate in Covid Associated Mucormycosis: Our Experience in 500 Patients. Indian J Otolaryngol Head Neck Surg 76, 1898–1902 (2024). https://doi.org/10.1007/s12070-023-04442-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-023-04442-5

Keywords

Navigation