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新冠患者鼻眶脑型毛霉菌病的趋势:一项观察性研究。

Trends of rhino-orbito-cerebral mucormycosis in COVID-19 patients: An observational study.

作者信息

Singh Nimmi, Singh Swati, Singh Priyankar, Mishra Navin, Sinha Bibhuti P, Shrama Arbind K

机构信息

Post Graduate Institute of Dental Education and Research, Indira Gandhi Institute of Medical Science, Patna, Bihar, India.

Post Graduate Institute of Dental Education and Research (Craniomaxillofacial Surgery), Indira Gandhi Institute of Medical Science, Patna, Bihar, India.

出版信息

J Family Med Prim Care. 2022 Dec;11(12):7891-7896. doi: 10.4103/jfmpc.jfmpc_1433_22. Epub 2023 Jan 17.

Abstract

BACKGROUND AND AIM

Mucormycosis is a potentially lethal but rare fungal infection that is rapidly progressive. Rhino-orbito-cerebral mucormycosis (ROCM) was the predominant presentation of COVID-19-associated mucormycosis (CAM). Hence, the present study aimed to assess the oral manifestations in CAM patients admitted to the Indira Gandhi Institute of Medical Sciences-A Tertiary Health Care Center.

MATERIALS AND METHODS

This study was conducted on hospitalized patients admitted to our tertiary health care center during the second wave of the COVID-19 pandemic. A total of 54 patients were included in the study and were further evaluated for oral manifestations. Detailed history, clinical examination, and surgical exploration was done for all the subjects. All cases were confirmed by MRI and histopathology.

RESULTS

Data collected was subjected to descriptive and inferential statistical analyses. Patients with oral manifestations were mostly in the age range of ≤50 years which was 56.7% ( = 17). Male patients 56.7% were affected more as compared to female patients and most of the patients in our study were from rural areas 56.7%. RBS [Mean ± standard deviation (SD)] was 304.60 ± 100.073. On intra-oral examination 96.7% had a gingival and palatal abscess, 63.3% had tooth mobility, and palatal ulcer/perforation was seen among 56.7% of the patients.

CONCLUSION

The second wave of the COVID-19 pandemic had also created an alarming situation in India and worldwide. Mucormycosis had come as a sudden storm which has created an emergency situation in our hospital and for dental practitioners also. This was also an alarming situation for a dental practitioner for evaluating early signs and symptoms, especially in high-risk patients and decreasing mortality.

摘要

背景与目的

毛霉菌病是一种潜在致命但罕见的真菌感染,进展迅速。鼻眶脑型毛霉菌病(ROCM)是新冠病毒相关毛霉菌病(CAM)的主要表现形式。因此,本研究旨在评估入住英迪拉·甘地医学科学研究所(一家三级医疗保健中心)的CAM患者的口腔表现。

材料与方法

本研究针对在新冠疫情第二波期间入住我们三级医疗保健中心的住院患者进行。共有54名患者纳入研究,并进一步评估其口腔表现。对所有受试者进行了详细的病史询问、临床检查和手术探查。所有病例均通过MRI和组织病理学确诊。

结果

收集的数据进行了描述性和推断性统计分析。有口腔表现的患者大多年龄在50岁及以下,占56.7%(n = 17)。男性患者受影响的比例为56.7%,高于女性患者,且我们研究中的大多数患者来自农村地区,占56.7%。随机血糖[平均值±标准差(SD)]为304.60±100.073。口腔内检查发现,96.7%的患者有牙龈和腭部脓肿,63.3%的患者有牙齿松动,56.7%的患者可见腭部溃疡/穿孔。

结论

新冠疫情的第二波在印度乃至全球也造成了令人担忧的局面。毛霉菌病如一场突如其来的风暴,给我们医院以及牙科医生都带来了紧急情况。对于牙科医生来说,评估早期症状和体征,尤其是在高危患者中,并降低死亡率,这也是一个令人担忧的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edda/10041009/e8441f525292/JFMPC-11-7891-g001.jpg

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