A clinical study of rhino-orbital-cerebral mucormycosis during the COVID-19 pandemic in western Maharashtra.

Autor:	Manade VV; Department of Ophthalmology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, Maharashtra, India., Kotecha MR; Department of Ophthalmology, Dr. D.Y. Patil Medical College and Hospital, Pimpri, Pune, Maharashtra, India.
Jazyk:	angličtina
Zdroj:	Journal of family medicine and primary care [J Family Med Prim Care] 2024 Sep; Vol. 13 (9), pp. 3730-3734. Date of Electronic Publication: 2024 Sep 11.
DOI:	10.4103/jfmpc.jfmpc_2_24
Abstrakt:	Background: The aim of the study was to describe the epidemiology and study the risk factors, clinical presentation, management, and outcome of rhino-orbital-cerebral mucormycosis (ROCM) in terms of mortality, exenteration, eye salvage, and vision salvage. Methods: This retrospective, observational study was carried out over a period of two months. A detailed history was noted, and an ophthalmological examination was done. The diagnosis was done by Potassium hydroxide (KOH) mount and fungal culture. Magnetic resonance imaging (MRI) of the orbit, brain, and paranasal sinuses were performed. Medical (intravenous amphotericin B, posaconazole), surgical (retrobulbar amphotericin B injection, exenteration, Functional Endoscopic Sinus Surgery (FESS)), or combined management was evaluated, and clinical outcomes was noted. Results: The mean age of patients was 54.2 years and the male-to-female ratio was 1.77/1. The most common underlying risk factor for ROCM was uncontrolled diabetes mellitus (70%), followed by the use of corticosteroids for the management of coronavirus disease 2019 (COVID-19) infection in 68% of patients. The most common clinical presentation was diminution of vision followed by eschar, ptosis, and proptosis. Medical and FESS were done in all patients; exenteration was done in 12% of patients. Sixty-six percent of patients were alive with regression of ROCM, 20% of patients were alive with residual, 8% of patients were alive with the progression of ROCM, and 6% of patients had expired. Among the ones who are alive, the ocular outcome was orbital exenteration in 12.76%, the eye was salvaged in 25.53 and vision salvage was achieved in 61.70%. Conclusion: ROCM affects older males. Immunosuppression due to COVID-19 infection, diabetes mellitus, and corticosteroid use in the management of COVID-19 are the main risk factors for the development of ROCM. Antifungal therapy along with surgical debridement decreases mortality. Competing Interests: There are no conflicts of interest. (Copyright: © 2024 Journal of Family Medicine and Primary Care.)
Databáze:	MEDLINE
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