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Academic literature on the topic 'Rhino Orbito Cerebral Mucormycosis (ROCM) COVID-19 Immunocompromised Diabetes Mellitus'
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Journal articles on the topic "Rhino Orbito Cerebral Mucormycosis (ROCM) COVID-19 Immunocompromised Diabetes Mellitus"
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Almyroudi, Maria Panagiota, Karolina Akinosoglou, Jordi Rello, Stijn Blot, and George Dimopoulos. "Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review." Diagnostics 12, no. 12 (2022): 3092. http://dx.doi.org/10.3390/diagnostics12123092.
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A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.
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Raj S, Pruthvi. "Glycemic Control Variations In Covid-19 Associated Mucormycosis”." UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY VOLUME 10, ISSUE II (2022): 36–41. http://dx.doi.org/10.36611/10.36611/upjohns/volume10/issue2/5.
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Background: Mucormycosis is opportunistic invasive fungal infection characterised by angioivasion, thrombosis and necrosis of the tissues. Diabetes mellitus being the commonest immunocompromised state predisposing to mucormycosis in India, a study about glycemic control in CAM (covid-19 associated mucormycosis) patients and the severity of mucormycosis was necessary so as to reduce the morbidity and mortality in CAM patients. Methods: A retrospective descriptive study was conducted between May 2021 and July 2021 at Bowring & Lady Curzon hospital. 315 patients with post-covid ROCM (rhino-orbito-cerebral mucormycosis) were included in the study. Glycemic control of the patients was monitored with FBS, PPBS, HBA1C values.The extent and severity of CAM was studied in patients with good and poor glycemic control.. Results: 243 (77.14%) patients were male and 72 (22.86%) were female. 296 (93.97% )patients had prior history of diabetes mellitus and 19 (6.03%) patients had newly detected diabetes mellitus. 275(87.30%) patients had poor glycemic control. 17 (6.18%) patients out of 275 presented with diabetic ketoacidosis (DKA). 40 (12.70%) patients had good glycemic control. Conclusions: Diabetes mellitus has emerged as important risk factor associated with development of mucormycosis. In covid-19, poorly controlled diabetes, steroid induced hyperglycemia, covid induced insulin resistance act as fertile land for the development of mucormycosis. Hence monitoring glycemic status, judicious use of steroids, control of sugars may help in reducing the severity or occurance of mucormycosis. Keywords: Mucormycosis, Diabetes mellitus, Covid-19 associated mucormycosis, Hyperglycemia.
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Puja, Priyadarshini, Kumar Jha Satyendra, and Dutta Verma Pranava. "An Observational Study to Investigate the Head and Neck Mucormycosis in Patients with Prior COVID-19 Infection." International Journal of Current Pharmaceutical Review and Research 15, no. 08 (2023): 564–68. https://doi.org/10.5281/zenodo.12570004.
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AbstractAim: The aim of the present study was to investigate the head and neck mucormycosis in patients with priorCOVID-19 infection.Methods: This cross-sectional study was conducted in the Department of Plastic Surgery, Nalanda MedicalCollege and Hospital, Patna, Bihar, India, We obtained the information by examining the data of patients whovisited Hospital with head and neck mucormycosis infection that occurred during or after the course of Covid-19infection for the period of one year. Among all 50 patients were included.Results: 30 (60) were men and 20 (40) were women, with a mean age of 56±12.6 years. 21 patients died due tomucormycosis, with a mean age of 60.0 ± 12.0 years (P-value=0.065), and those who survived had a mean age of52.4 ± 12.0 years. The correlation of the clinical symptoms with the recurrence of mucormycosis and the outcomeof the cases showed statistically significant differences in the outcome of patients with positive visual symptomsand orbital bone involvement.Conclusion: The COVID-19 pandemic has caused an increase in the occurrence of mucormycosis, a fungalinfection. This global health challenge has also led to a rise in secondary illnesses, including mucormycosis.Specifically, Rhino-orbito-cerebral mucormycosis (ROCM) in the head and neck area has been found to have ahigh mortality rate and can cause severe damage to the eyes, bones, and surrounding tissues. This investigationhas established a clear connection between mucormycosis and visual impairment, involvement of the ethmoidalbone, and orbital involvement, all of which contribute to a higher mortality rate. Diagnosing mucormycosis inCOVID-19 patients is challenging due to the absence of specific clinical features and reliable diagnostic tests
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Patel, Seema, B. D. Bokare, A. Keche, D. Birhade, A. Kuthe, and R. Darokar. "MUCORMYCOSIS IN COVID 19- 2ND WAVE : CLINICAL PROFILE IN CENTRAL INDIA." International Journal of Advanced Research 10, no. 01 (2022): 785–89. http://dx.doi.org/10.21474/ijar01/14108.
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A sudden surge of Rhino-Orbito-Cerebral Mucormycosis (ROCM) was observed following second wave of Covid-19 in India. Diabetes mellites (DM) , steroids, hypoxia, hyperglycemia ,metabolic acidosis or Diabetic ketoacidosis, high serum iron levels, zinc supplementation, immunosuppression along with other risk factors have been found to facilitate fungal germination. Patients diagnosed with ROCM, a total of 273, were included in the study. Detailed history was noted and assessment was done. Male:Female ratio was 2.59:1. Most common presenting age group was 31 to 50 yrs (51.65%). The commonest presenting symptom was nasal obstruction (58.97%) followed by ipsilateral facial swelling (53.11%). Palatal ulceration, blood stained nasal discharge ,orbital swelling, diminution or loss of vision, headache, loosening of teeth were among other presentations. Common associated comorbidity was diabetes(84.61%), hypertension (HTN) , anemia, immunocompromised state etc. History of associated past covid infection was seen in 75.52% while 18.68% had coexisting mucor with covid. History of steroid use was in 86.81%, O2 administration by mask in 64.10%, ventilatory support in 5.12 % and tablet zinc intake in 86.45%. Covid-19 along with DM, HTN, anemia, steroid therapy and oxygen therapy are the risk factors for ROCM. Thus regular blood sugar monitoring , judicious use of corticosteroids, maintaining hygiene of mask and circuit during oxygen therapy is recommended while treating covid.
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Mishra, Sameeksha, Dhaval Bhojani, and Sudhakar Vaidya. "Presentation of mucormycosis in post Covid-19 infected patients and an approach to its management in a tertiary care centre of central India." IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain 9, no. 1 (2023): 1–5. http://dx.doi.org/10.18231/j.ijashnb.2023.001.
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Background: This is a case study of 70 cases admitted in our hospital post covid-19 infection with different complaints and signs and symptoms indicating Rhino-Orbital-Cerebral-mucormycosis (ROCM). Materials and Methods: All the cases were again screened for COVID infections and comorbidities like Diabetes mellitus, Hypertension or any other immunocompromised state. The level of involvement like nasal cavity, septum, turbinates, sinuses, pterygopalatine fossa, palate, orbit or any cerebral involvement was noted and the protocol of medical and surgical management was decided in accordance to that. Post surgery KOH mount and HPE report, CT and MRI findings were the major pillars in this regard. Results: In 100% of cases we did middle meatus antrostomy with partial middle turbinectomy and in 57% cases we did medial maxillectomy with Modified Denker’s.Rest middle meatus mega antrostomy with ethmoidectomy with partial middle turbinectomy & full house FESS was done in 21% of cases. Conclusion: The first step in the management of mucormycosis is to have a high index of clinical suspicion especially in those with COVID- 19 who have diabetes mellitus, and who have received systemic corticosteroids while on treatment.
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Kapoor, Sahil, Poonam Kumar Saidha, Ayushi Gupta, Urvi Saini, and Sneha Satya. "COVID-19 Associated Mucormycosis with Newly Diagnosed Diabetes Mellitus in Young Males – A Tertiary Care Experience." International Archives of Otorhinolaryngology 26, no. 03 (2022): e470-e477. http://dx.doi.org/10.1055/s-0042-1748927.
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Abstract Introduction Patients with a history of or active COVID-19 infection are predisposed to the development of opportunist bacterial and fungal infections. A rising incidence of a rare occurring fungal infection earlier, called mucormycosis, has been reported in abundance across the globe since March 2021, especially in India just as the second wave of COVID-19 began, caused by the trifecta of hyperglycemia (new-onset or exacerbation of pre-existing diabetes), oxygen therapy (invasive or noninvasive ventilation), and prolonged intake of steroids. Objective The present study aimed at assessing the prevalence of post-COVID mucormycosis in males of younger age group and spread of rhino-orbital-cerebral mucormycosis (ROCM). Methods A case-control study was performed over a period of 3 months among 60 male patients with confirmed diagnosis of mucormycosis. Individuals < 40 years old were included in the case group (n = 30), while those > 40 years old were included as controls (n = 30). Disease spread was assessed in three types of ROCM, that is, rhinomaxillary, rhino-orbital, and rhino-orbito-cerebral mucormycosis. Results In the control group, the mean age was 48.47 years old, the mean HbA1c was 10.62 ± 1.88%, with most of them suffering from rhino-orbital mucormycosis. In the case group, the mean age was 31.57 years old, with a mean HbA1c of 10.11 ± 2.46%, and most patients had rhinomaxillary mucormycosis. The duration of steroid intake and mode of oxygen therapy were found to be significant in the severity of ROCM. Conclusion Rising cases of post-COVID mucormycosis have brought to light the fatal consequences of prolonged use of steroids and oxygen therapy towards the development and spread of ROCM among young and middle-aged males.
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A., Veena H., Manjunath Bhusanoor, Bharath R., Supriya Bhakthavatchalam, and Narayanswamy Madappa. "Interesting presentations of mucormycosis in post-COVID patients." International Journal of Advances in Medicine 9, no. 6 (2022): 737. http://dx.doi.org/10.18203/2349-3933.ijam20221366.
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Most documented cases of mucormycosis have been reported in patients with uncontrolled diabetes mellitus, neutropenia, or treatment with corticosteroids. Recently, with the second wave of COVID-19, the Indian subcontinent has witnessed a dramatic rise in mucormycosis infection in patients recovered from COVID-19. This association has been documented in various case reports/case series and institutional studies, and the mortality associated with this fungal infection is emerging as a cause of concern. Pulmonary mucormycosis is the second most common form after rhino-orbito-cerebral mucormycosis (ROCM), but most cases are diagnosed in autopsy specimens. Cutaneous, Gastro-intestinal and disseminated forms are relatively rare. This cases series comprises of 4 cases of mucormycosis in post-COVID patients with interesting presentations. We report two cases of combined pulmonary aspergillosis and pulmonary mucormycosis, one case of rhino-orbital-mucormycosis with lymph nodal involvement and one case of rhino-orbital mucormycosis with acute inflammatory demyelinating polyneuropathy (AIDP).
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Saberi, Hooshang, Nazi Derakhshanrad, Pedram Sedaghat, Ehsan Jaberansary, Asghar Hajipour, and Pouyan Aminishakib. "Successful Treatment of Acute Invasive Rhino-Orbito-Cerebral Mucormycosis Associated with COVID -19: Case Report and Literature Review." Iranian Journal of Neurosurgery 8, Continuous publishing (2022): 18. http://dx.doi.org/10.32598/irjns.8.18.
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Background and Aim: Mortality associated with post-coronavirus disease 2019 (COVID-19) rhino-orbital cerebral mucormycosis (ROCM) is an evolving concern. Association of COVID-19, corticosteroid therapy, and uncontrolled diabetes mellitus (DM) are considered predisposing factors for ROCM. We present two cases of successful treatment leading to patient survival for post-COVID-19, stage 4c-ROCM. Case Presentation: Two middle-aged men with poorly controlled DM were referred to our hospital for post-COVID-19 ROCM. They had received intravenous antivirals and dexamethasone as treatment in a primary center. Both patients had unilateral oculofacial pain and swelling followed by acute visual loss, unilateral proptosis, facial palsy, and trigeminal hypoesthesia. A computed tomography scan revealed opacity and bony erosion of paranasal sinuses (PNS). Obtained specimens confirmed mucormycosis agent on histopathological examination. After the failure of conservative treatments, retrobulbar injections of liposomal-amphotericin B, PNS debridement, and orbital exenteration, both patients developed blurred consciousness owing to the extension of the infection into the intracranial cavity. Brain magnetic resonance imaging revealed a right frontal lobe abscess in case 1 and a left frontal sinus abscess and involvement in case 2. Both underwent transcranial debridement and resection of necrotic tissue and drainage of the abscess. At follow-up, the patients were in good condition, and the fungal cultures were negative for mucormycosis agents. Conclusion: ROCM may be a complication of COVID-19 in high-risk patients. Control of the patient’s underlying systemic condition and prompt treatment with antifungal agents, along with timely aggressive resection of cerebral abscess and necrotic paranasal tissues, are the mainstays of management for ROCM.
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Ponnaiah, Manickam, Sivaraman Ganesan, Tarun Bhatnagar, et al. "Hyperglycemia and steroid use increase the risk of rhino-orbito-cerebral mucormycosis regardless of COVID-19 hospitalization: Case-control study, India." PLOS ONE 17, no. 8 (2022): e0272042. http://dx.doi.org/10.1371/journal.pone.0272042.
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Background In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. Methods We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. Results Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45–59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. Conclusions Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.
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Sontakke, Ashwini Y., Vaishnavi V. Kulkarni, Nitin N. Nandanvankar, and Sachin Totawar. "Anesthesia Management of COVID-19 associated Rhino-Orbito-Cerebral Mucormycosis: A Prospective Observational Study." Perspectives in Medical Research 12, no. 1 (2024): 12–18. http://dx.doi.org/10.47799/pimr.1201.03.
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Abstract Background: Fungal infections (mucormycosis) have been reported as co-infection as well as opportunistic infection during and after COVID-19 (Coronavirus disease), involving the paranasal air sinuses with a high risk of morbidity and mortality. Considering the ongoing situation of COVID-19 associated with mucormycosis, we presented our experience of 110 patients being, or having previously been COVID -19 positive. Methods: This study included 110 patients in which surgical resection was done for Rhino-orbito-cerebral mucormycosis (ROCM) under general anesthesia and observed for 30 days postoperatively. Results: This study included 79 male patients with the majority of 51-60 years of age group (31.81%). Most common comorbidities observed in study were diabetes mellitus (77.27 %) followed by hypertension (39.09 %) & ischemic Heart Disease (9.09 %). Majority patients had received steroids (80 %) as a part of covid-19 treatment. All patients were receiving Amphotericin B at the time of surgery. On operative table extubation was possible in 80 % of the cases while others required average ICU stay (9.83 ± 7.33 days). Inotropic support was required in 20 % of patients. Majority patients were discharged successfully (85.45 %), while 10.91 % had mortality. On 30 days follow-up frontal Sinus Abscess (6.36 %) & maggots in maxilla and sphenoid (0.91 %) were noted. Conclusion: Corticosteroids and DM are the most important predisposing factors in the development of COVID-19-associated ROCM. Perioperative anesthesia care plays an important role towards management and outcome of ROC mucormycosis. Difficult intubation is anticipated due to fungal debris and supraglottic edema in the oropharynx of the patient.