Agarwal Varsha, Gupta Ambika, Singh Virendra, Kumia Komal, Saini Bhawna, Suriya N
Dept. of Oral Medicine and Radiology, Post Graduate Institute of Dental Sciences, Rohtak, India.
Dept. of Oral and Maxillofacial Surgery, Post Graduate Institute of Dental Sciences, Rohtak, India.
J Oral Biol Craniofac Res. 2023 May-Jun;13(3):412-417. doi: 10.1016/j.jobcr.2023.04.002. Epub 2023 Apr 21.
To evaluate the prevalence of risk factors associated with COVID-associated mucormycosis (CAM) in the maxillofacial region with emphasis on clinical and radiological characteristics of the disease reporting to the dentists.
Archival records of the patients diagnosed with rhino-cerebral mucormycosis through histopathology or culture, were screened and 266 records were included. These records were divided into three groups-previously diabetic (PD, n = 122), recently diagnosed diabetic (RD, n = 105) and non-diabetic (ND, n = 39). All the records were evaluated and compared among the three groups for the duration of presentation, history of co-existing medical conditions, the association of treatment given during COVID-19, and the clinical and radiographic presentations of the disease.
The results confirmed uncontrolled diabetes mellitus as the major risk factor for the disease. The prevalence of steroid administration was lower in our study in contrast to previous literature. The risk factors and treatment rendered during COVID-19 did not differ significantly among the three groups (p > 0.05). The findings indicate that the disease was milder and progressed more slowly in the ND group, both clinically and radiographically, and it had close resemblance to odontogenic infection.
Patients with early CAM mimicked the odontogenic infection and were more likely to report in a dental setup. Hence, a multidisciplinary and holistic management approach is necessary.
评估颌面部与新冠相关毛霉菌病(CAM)相关危险因素的患病率,重点关注向牙医报告的该疾病的临床和放射学特征。
筛选通过组织病理学或培养诊断为鼻脑毛霉菌病患者的档案记录,纳入266份记录。这些记录分为三组——既往糖尿病患者(PD,n = 122)、近期诊断为糖尿病的患者(RD,n = 105)和非糖尿病患者(ND,n = 39)。对所有记录进行评估,并在三组之间比较就诊时间、并存疾病史、新冠疫情期间所接受治疗的相关性以及该疾病的临床和影像学表现。
结果证实未控制的糖尿病是该疾病的主要危险因素。与既往文献相比,我们研究中类固醇给药的患病率较低。三组之间在新冠疫情期间的危险因素和所给予的治疗无显著差异(p > 0.05)。研究结果表明,该疾病在非糖尿病组中临床和影像学表现均较轻且进展较慢,与牙源性感染非常相似。
早期CAM患者表现类似牙源性感染,更有可能在牙科机构就诊。因此,多学科和整体管理方法是必要的。