Original Articles
Clinical findings and treatment of rhino-orbital mucormycosis | |
Dr. Baidya Nath Majhi, Dr. Gireesh Mishra, Dr. Ashok Mani Tripathi | |
Background: Mucormycosis presents with a range of clinical symptoms with isolated involvement of many systems. Rhino-orbital cerebral and pulmonary disorders are the most prevalent and deadly symptoms. After the COVID-19 second wave, there was an increase in incidents, and because of the severe clinical presentation and scarcity of available treatments, there was cause for immediate worry. Objective: To evaluate the clinical manifestations and therapeutic results of rhino-orbital-cerebral mucormycosis patients who come to a central Indian tertiary care facility. Methods: This is a longitudinal clinical study. We observed 28 instances of steroid-dependent hyperglycemia, and COVID-19 associated mucormycosis patients. We collected and analyzed their medical histories, surgical procedures, microbiological and radiological findings, clinical symptoms, underlying systemic diseases, and demographic information. Outcomes were noted after 1 month Amphotericin B treatment (intravenously at a dose of 1 mg/kg each day). Results: There were a total of 28 patients, with a mean age of 52.3 years. Thirteen patients had type 2 diabetes mellitus, 15 patients (53.6%) were on anti-hypertensive therapy,3 patients were HIV infected and getting antiretroviral medication and 19 patients were COVID-19-related mucormycosis. These patients showed ophthalmoplegia, proptosis, orbital cellulitis, vision loss, central retinal artery blockage, and optic atrophy and 3 individuals had cerebral involvement. Every single one of the 28 patients (100%) had primary surgery of endoscopic debridement of sinuses. Effect of treatment on visual acuity and functional improvement was not so favourable. Conclusion: A multimodal approach of early identification, blood sugar management, immediate systemic antifungal medication, and sinus debridement surgery can be lifesaving in deadly condition known as invasive rhino-orbital-cerebral mucormycosis. |
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