Authors :
Dr. K. Shanti; Dr. K. Kishore; Dr. G. Siva Prasad; Dr. A. Dhivya
Volume/Issue :
Volume 8 - 2023, Issue 1 - January
Google Scholar :
https://bit.ly/3IIfn9N
Scribd :
https://bit.ly/3XWOWpk
DOI :
https://doi.org/10.5281/zenodo.7592787
Abstract :
The incidence of mucormycosis increased
dramatically after the COVID-19 pandemic which was
named CAM (covid associated mucormycosis). The
number of published articles on mucormycosis increased
from 74 in the year 2000 to 786 in the year 2022 [2]. It
indicates the increasing disease burden. Mucormycosis
prevalence in India is estimated to be 140 cases per million
people, which is almost 80 times greater than the incidence
in wealthy nations. Death was reported in 389/851 (46%)
patients in a systemic review and meta-analysis of 851 case
reports published in 2018. In May 2021, several Indian
states declared mucormycosis a notifiable disease in
response to the rise in COVID-19-associated
mucormycosis [1].
Methods: For all the patients who are suspected to have
mucormycosis, nasal scrapings were taken under
endoscopic guidance and sent for KOH mount and culture.
Regardless of the microbiological evidence, based on
diagnostic nasal endoscopic findings alone we subjected all
patients to MRI brain and PNS and Orbits multiplanar
fat-suppressed images with and without contrast. A sum of
300 patients who are confirmed to have mucormycosis
early or late in the course of treatment and for which who
received surgical and medical management was included
in the study.
Results: All 300 patients received intravenous liposomal
amphotericin B. 17 patients underwent limited surgical
debridement; 137 patients underwent the modified
denkers approach for surgical debridement; 146 cases
underwent infrastructure maxillectomy. Among them, 18
cases (8%) needed revision surgical debridement within 1
year of follow-up. Only one patient died postoperatively
out of 300 patients showing a mortality rate of 0.33%
Conclusion: Early diagnosis of mucormycosis remains
difficult and is a significant unmet need, creating a
bottleneck in developing novel, efficient clinical
interventions. Early surgical debridement along with
antifungal helps in reducing mortality greatly.
Keywords :
Immunosuppression, Liposomal Amphotericin-B, Mucormycosis, CAM.
The incidence of mucormycosis increased
dramatically after the COVID-19 pandemic which was
named CAM (covid associated mucormycosis). The
number of published articles on mucormycosis increased
from 74 in the year 2000 to 786 in the year 2022 [2]. It
indicates the increasing disease burden. Mucormycosis
prevalence in India is estimated to be 140 cases per million
people, which is almost 80 times greater than the incidence
in wealthy nations. Death was reported in 389/851 (46%)
patients in a systemic review and meta-analysis of 851 case
reports published in 2018. In May 2021, several Indian
states declared mucormycosis a notifiable disease in
response to the rise in COVID-19-associated
mucormycosis [1].
Methods: For all the patients who are suspected to have
mucormycosis, nasal scrapings were taken under
endoscopic guidance and sent for KOH mount and culture.
Regardless of the microbiological evidence, based on
diagnostic nasal endoscopic findings alone we subjected all
patients to MRI brain and PNS and Orbits multiplanar
fat-suppressed images with and without contrast. A sum of
300 patients who are confirmed to have mucormycosis
early or late in the course of treatment and for which who
received surgical and medical management was included
in the study.
Results: All 300 patients received intravenous liposomal
amphotericin B. 17 patients underwent limited surgical
debridement; 137 patients underwent the modified
denkers approach for surgical debridement; 146 cases
underwent infrastructure maxillectomy. Among them, 18
cases (8%) needed revision surgical debridement within 1
year of follow-up. Only one patient died postoperatively
out of 300 patients showing a mortality rate of 0.33%
Conclusion: Early diagnosis of mucormycosis remains
difficult and is a significant unmet need, creating a
bottleneck in developing novel, efficient clinical
interventions. Early surgical debridement along with
antifungal helps in reducing mortality greatly.
Keywords :
Immunosuppression, Liposomal Amphotericin-B, Mucormycosis, CAM.
