George Sonith Peter, Bhalot Lokesh, Verma Jagram, Godha Surbhi, Gupta Yamini, Mundra R K
Department of Otorhinolaryngology, M.G.M Medical College, 301-A, Elite Anmol, Shree Mangal Nagar, Near Bengali Square, Indore, M.P. 452016 India.
Department of Otorhinolaryngology Medical College, Ratlam, M.P India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3501-3506. doi: 10.1007/s12070-023-04014-7. Epub 2023 Jul 3.
In this study, we attempt to look at the various presentations, comorbidities and association of the recent epidemic of rhino-orbital cerebral mucormycosis with Covid-19 in central India. A prospective study of 612 patients diagnosed with mucormycosis from April to July 2021. Detailed history was taken and thorough clinical examination was done. The relation of mucormycosis with Covid-19 and other morbidities was studied. Nasal endoscopy, imaging and management findings were tabulated and analyzed. Male predominance of the disease was noted. The most common age group affected was found to be 41-50 years group having 33.1% of all patients. 83.2% patients had history of Covid-19 infection. Majority of the patients (41.6%) had mucormycosis symptoms within 1 month of Covid-19 symptom onset. Nasal symptoms predominated with 61.1% patients having one or more of the several nasal symptoms. Most common comorbidity was diabetes mellitus (75.8% cases). Nasal and sinus debridement was performed in 584 patients (95.4%). Mucormycosis turned into a widespread epidemic during the second wave of Covid-19 in India. Diabetes mellitus was the most common associated comorbidity that increased the risk of mucormycosis in patients with history of Covid-19 infection. A high index of suspicion in patients presenting with early symptoms in the context of Covid-19, along with prompt diagnosis using radiological, endoscopic and microbiological tools will help reduce mortality to a great extent. Mainstay of treatment is aggressive surgical and medical management, controlling comorbidities and adequate post-operative care.
在本研究中，我们试图观察印度中部近期鼻眶脑毛霉菌病流行的各种表现、合并症及其与新冠肺炎的关联。对2021年4月至7月诊断为毛霉菌病的612例患者进行了一项前瞻性研究。记录了详细病史并进行了全面临床检查。研究了毛霉菌病与新冠肺炎及其他疾病的关系。将鼻内镜检查、影像学检查及治疗结果制成表格并进行分析。发现该病男性居多。受影响最常见的年龄组为41 - 50岁组，占所有患者的33.1%。83.2%的患者有新冠肺炎感染史。大多数患者（41.6%）在新冠肺炎症状出现后1个月内出现毛霉菌病症状。鼻部症状最为突出，61.1%的患者有一项或多项鼻部症状。最常见的合并症是糖尿病（75.8%的病例）。584例患者（95.4%）接受了鼻及鼻窦清创术。在印度新冠肺炎第二波疫情期间，毛霉菌病成为一种广泛流行的疾病。糖尿病是最常见的相关合并症，增加了有新冠肺炎感染史患者患毛霉菌病的风险。对于新冠肺炎背景下出现早期症状的患者保持高度怀疑指数，同时使用放射学、内镜及微生物学工具进行快速诊断，将有助于在很大程度上降低死亡率。治疗的主要方法是积极的手术和药物治疗、控制合并症以及充分的术后护理。
