A black intruder into the Pandemic: Rhino-Orbital Mucormycosis Complicating COVID-19

Abstract

There is an increased incidence of rhino orbital mucormycosis during the Coronavirus Disease-2019 (COVID-19) pandemic attributed to diabetes mellitus, corticosteroid usage and immunocompromise caused by COVID-19. In this series, seven biopsy proven cases of mucormycosis (six male patients and one female patient) are presented from a tertiary care center in Eastern India from (May 2021 to June 2021). Empirical systemic liposomal amphotericin B, radical sinus surgery with orbital decompression and irrigation of sinus and orbit with amphotericin B was performed. The mean age of the patients were 42.71±7.34 years with a male preponderance (85.7%). Five patients had orbital involvement (71.42%), and two had cerebral involvement (28.6%). All of them had elevated blood glucose levels, though only three (42.85%) were known cases of type 2 diabetes. The most common manifestations were sinus tenderness (100%), paresthesia (100%), facial swelling (71.42%) and nasal discharge (28.57%). Follow-up at two months showed zero mortality. Timely diagnosis, appropriate management with intravenous amphotericin B and endoscopic radical sinus surgery, debridement of the necrotic tissue proved to be necessary for a good outcome in rhino-orbito-cerebral mucormycosis.