Patel Viral B, Patel Aashvi, Mishra Girish, Shah Nilay, Shinde Mayur K, Musa Raish K
Department of Radio Diagnosis, Pramukh Swami Medical College and Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India.
Department of Otolaryngology, Medical Officer, IRIS Hospital, Anand Gujarat, India.
J Family Med Prim Care. 2023 Jun;12(6):1055-1062. doi: 10.4103/jfmpc.jfmpc_1189_22. Epub 2023 Jun 30.
Coronavirus Disease 2019 (COVID-19) has been speculated to enhance mucormycosis infection due to its immune-altering pathophysiology. Early identification of high-morbidity conditions is crucial for optimal treatment and improved outcomes.
A retrospective study was conducted on 63 patients with clinical and microbiological evidence of rhino-ocular-cerebral mucormycosis, who had a history of COVID-19 infection. The clinical, demographic, and imaging data were retrieved and analyzed. Descriptive statistics (mean [SD] and frequency [%]) were used to describe important characteristics across audit cycles.
Out of 63 patients, 54 (85.71%) patients had associated comorbidities, with diabetes mellitus being common comorbidity and all patients had received injectable and/or oral corticosteroids. Imaging showed nasal and paranasal sinus, perisinus, maxillary alveolar arch, and hard palate involvement in 62 (98.41%), 33 (52.38%), 5 (7.94%) and 5 (7.94%) patients, respectively. Orbital involvement was seen in 24 (38.10%) patients. Skull base involvement was seen in 11 (17.46%) patients, and intracranial extension of disease was present in 11 (17.46%) patients. A total of 16 patients were on mechanical ventilation, of whom 3 succumbed. The mean (standard deviation [SD]) intensive care unit (ICU) stay was 13.2 days (6.8) for 5 patients who succumbed and 6.4 days (4.6) for 30 patients who survived ( value = 0.008).
Cross-sectional imaging not only provides the extent of disease spread but also plays a vital role in providing a surgical roadmap to treating surgeons and in predicting prognosis in patients with invasive fungal infections.
2019冠状病毒病（COVID-19）因其改变免疫的病理生理学机制，被推测会增加毛霉病感染风险。早期识别高发病情况对于优化治疗和改善预后至关重要。
对63例有COVID-19感染史且有鼻-眼-脑毛霉病临床及微生物学证据的患者进行回顾性研究。收集并分析临床、人口统计学和影像学数据。采用描述性统计（均值[标准差]和频率[百分比]）来描述各审核周期的重要特征。
63例患者中，54例（85.71%）有合并症，糖尿病是常见合并症，所有患者均接受过注射用和/或口服糖皮质激素治疗。影像学检查显示，62例（98.41%）患者有鼻腔及鼻窦、鼻窦周围、上颌牙槽弓和硬腭受累，33例（52.38%）、5例（7.94%）和5例（7.94%）患者分别有相应部位受累。24例（38.10%）患者有眼眶受累。11例（17.46%）患者有颅底受累，11例（17.46%）患者有疾病颅内扩展。共有16例患者接受机械通气，其中3例死亡。5例死亡患者的重症监护病房（ICU）平均住院时间为13.2天（6.8天），30例存活患者为6.4天（4.6天）（P值 = 0.008）。
横断面成像不仅能显示疾病的扩散程度，还在为外科医生提供手术路线图以及预测侵袭性真菌感染患者的预后方面发挥着至关重要的作用。
