Glaucoma unit, Department of ophthalmology, M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India.
Indian J Ophthalmol. 2022 Apr;70(4):1371-1375. doi: 10.4103/ijo.IJO_2943_21.
Rhino-orbital-cerebral mucormycosis (ROCM) is a rare opportunistic fungal infection with a fulminant course and an often fatal outcome. It can occur in immune-compromised patients such as those having uncontrolled diabetes, on long-term corticosteroid or immunosuppressive therapy, with COVID-19 infection, renal failure, AIDS, malignancy, or organ transplant. The aim of our study was to study the epidemiology of mucormycosis in COVID-19 patients and identify its risk factors.
Ours was an epidemiological study wherein we gathered the demographic, clinical, histopathological, and radiological data of 458 patients of mucormycosis who presented to us between August 2020 and May 2021. Mucormycosis was defined through clinical and radiological findings or positive culture reports.
Out of all, 20.74% of patients did not have any past or concurrent history of COVID-19. The most common symptom of mucormycosis was orbital/facial pain (38.64%) and the most common sign was periocular/facial edema (50.74%). Mucormycosis involving the nose and sinuses (94.54%) was most common followed by rhino-orbital (45.41%) and brain involvement (10.04%). The most common risk factor for mucormycosis was diabetes [81.92%], followed by corticosteroid use [79.69%] and supplemental oxygen [48.90%]. Most of the patients received similar treatment with IV amphotericin B [88.64%] and local debridement [80.74%].
With the third wave of COVID-19 still lurking, a fatal fungal infection should be kept in mind in COVID-19 active as well as recovered patients, especially those who have co-morbid medical conditions such as uncontrolled diabetes and who are treated with large doses of corticosteroids.
鼻窦-眶-脑毛霉病（ROCM）是一种罕见的机会性真菌感染，具有暴发性病程和常导致死亡的结局。它可发生于免疫功能低下的患者，如患有未控制的糖尿病、长期接受皮质类固醇或免疫抑制剂治疗、感染 COVID-19、肾衰竭、艾滋病、恶性肿瘤或器官移植的患者。我们研究的目的是研究 COVID-19 患者中毛霉病的流行病学，并确定其危险因素。
这是一项流行病学研究，我们收集了 2020 年 8 月至 2021 年 5 月期间来我院就诊的 458 例毛霉病患者的人口统计学、临床、组织病理学和影像学数据。毛霉病的定义是通过临床和影像学发现或阳性培养报告。
在所有患者中，20.74%的患者没有任何过去或同时存在的 COVID-19 病史。毛霉病最常见的症状是眶/面部疼痛（38.64%），最常见的体征是眼周/面部水肿（50.74%）。最常见的病变部位是鼻和鼻窦（94.54%），其次是鼻窦-眶（45.41%）和脑受累（10.04%）。毛霉病最常见的危险因素是糖尿病[81.92%]，其次是皮质类固醇使用[79.69%]和补充氧气[48.90%]。大多数患者接受了类似的治疗，包括静脉注射两性霉素 B[88.64%]和局部清创术[80.74%]。
随着第三波 COVID-19 的持续存在，在 COVID-19 活跃和康复的患者中，特别是那些患有未控制的糖尿病等合并症且接受大剂量皮质类固醇治疗的患者中，应注意这种致命的真菌感染。
