Open AccessA RETROSPECTIVE STUDY OF RHINO-ORBITAL MUCORMYCOSIS
Author(s) -
Shubha Srinivasan,
Divya Pankajakshan,
A. Rohini,
R. Jayapreethi
Publication year - 2021
Publication title -
paripex indian journal of research
Language(s) - English
DOI - 10.36106/paripex/2106475
Subject(s) - mucormycosis , medicine , cavernous sinus thrombosis , paranasal sinuses , retrospective cohort study , diabetes mellitus , surgery , neutropenia , dermatology , pediatrics , thrombosis , chemotherapy , endocrinology
BACKGROUND: Mucormycosis is a rapidly progressing, life threatening, opportunistic fungal infection caused byangioinvasive mucorales species of the phylum zygomycetes.The major risk factors of the disease are uncontrolleddiabetes mellitus, COVID-19 infection,prolonged usage of high dose of systemic corticosteroids,immunocompromisedstatus and neutropenia. These create a nidus for fungal infection through nasal mucosa which spreads up throughparanasal sinuses into orbit manifesting as rhino-orbital mucormycosis.AIM1. To study the epidemiology and various clinical patterns of presentation of rhino-orbital mucormycosis in post covidpatients.2. To analyse the risk factors associated with progression of rhino-orbital mucormycosis in post covid patients.METHODS: A retrospective study of 25 patients diagnosed as rhino-orbital mucormycosis in post covid patients atGovernment Kilpauk Medical College Hospital between April and July 2021 was done.RESULTS: In our study,males (64%) are more commonly affected with age preponderance of 51-60 years(28%). Themean age of presentation was 52.1+/-4.49years.The most common symptom of the disease is nasal discharge with sinusand orbital pain(52%).The most common form of presentation is orbital apex syndrome in seven patients(28%).Fivepatients had loss of vision, of which four were due to central retinal artery occlusion(16%) and one due to cavernoussinus thrombosis.MRI imaging of these patients showed sinus involvement(100%) in all cases ,orbital(48%) and cerebralinvolvement(8%).The major risk factors responsible for progression of disease in our study are uncontrolled diabetes,prolonged usage of high dose steroid therapy, medial wall involvement, optic nerve head involvement and arterythrombosis.CONCLUSION: Post covid patients presenting with nasal discharge with sinus and orbital pain symptoms need to bediagnosed and managed properly to avoid spread of infection and fatal complications. Aggressive surgicaldebridement of infected tissues helps in increasing the survival rate of the patients. Patients with risk factors need to beclosely monitored to prevent vision loss and cosmetic disfigurement surgeries.