Bhardwaj Rohit, Sharma Akriti, Parasher Ankit, Gupta Harshita, Sahu Subhankar, Pal Soni
Department of Otorhinolaryngology, VMMC and Safdarjung Hospital, New Delhi, India.
Department of Otorhinolaryngology, SGT Medical College, Hospital and Research Institute, Gurgaon, Haryana India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):3492-3497. doi: 10.1007/s12070-021-02978-y. Epub 2021 Nov 12.
Mucormycosis is a life threatening, opportunistic infection often seen in individuals with a weak immune system. With an upsurge of cases of Covid-19, a drastic increase in cases of Rhino-Orbito-Cerebral Mucormycosis is being witnessed at present. This article has been written with the purpose of understanding the factors responsible for it and the challenges it brings along for the Indian health-care system at present. Possible solutions for dealing with these problems have also been included in the manuscript. Google, PubMed and ENT Cochrane databases were searched without a time limit using key words like "Mucormycosis", "Rhino-cerebral-mucormycosis" in conjunction with "COVID-19" and "SARS CoV-2". We found 34 articles to be relevant and hence included them to write this review. Rhino-Orbito-Cerebral Mucormycosis is being seen due to coming together of the three entities-the agent, host and environment that constitute the epidemiological triad for this disease in India. Responsible factors are uncontrolled diabetes mellitus, overzealous use of steroids and antibiotics and other environment related issues. The solutions for these problems lie in spreading awareness about prevention of these practices along with early diagnosis and treatment of mucormycosis. To deal effectively with this situation, particularly when there is an existing overload on otolaryngologists and the rest of the health-care system, a multipronged and multilevel collaborative approach is the need of the hour. With effective Standard Operating Procedures and guidelines promoting a multidisciplinary approach for early diagnosis and treatment, we can surely overcome this situation.
毛霉菌病是一种危及生命的机会性感染，常见于免疫系统较弱的个体。随着新冠肺炎病例的激增，目前鼻眶脑毛霉菌病的病例也在急剧增加。撰写本文的目的是了解其成因以及目前它给印度医疗系统带来的挑战。本文还包括了应对这些问题的可能解决方案。我们在谷歌、PubMed和耳鼻喉科Cochrane数据库中进行了不限时间的检索，使用了“毛霉菌病”“鼻脑毛霉菌病”等关键词，并结合“新冠肺炎”和“严重急性呼吸综合征冠状病毒2”。我们发现34篇文章相关，因此将它们纳入撰写本综述。在印度，鼻眶脑毛霉菌病的出现是由于构成该疾病流行病学三角的三个要素——病原体、宿主和环境共同作用的结果。相关因素包括未控制的糖尿病、过度使用类固醇和抗生素以及其他与环境有关的问题。这些问题的解决办法在于提高对预防这些行为的认识，以及对毛霉菌病进行早期诊断和治疗。为了有效应对这种情况，特别是在耳鼻喉科医生和其他医疗系统已经不堪重负的情况下，多管齐下、多层次的协作方法是当务之急。通过有效的标准操作程序和指南，推广多学科方法进行早期诊断和治疗，我们肯定能够克服这种情况。
