A RETROSPECTIVE ANALYSIS OF HISTOPATHOLOGICAL FINDINGS IN RHINOORBITAL FUNGAL INFECTION IN POST COVID 19 PATIENTS

Abstract

Introduction: Health care sector across India reported signicant increase in cases of covid linked mucormycosis and other fungal infections in covid 2nd wave. Mucormycosis is an opportunistic fulminant fungal infection in immunocompromised host. Concomitant diabetes and use of high dose steroid, further add to already compromised immunity in covid patients. It may manifest as rhino-orbital or cerebral mucormycosis. Fungus invades the arterioles and causes tissue necrosis, which is the hallmark of mucormycosis. Objectives: To study frequency and histomorphology of various tissue invasive fungal infections and their corelation with other parameters. Material and Methods: This is retrospective observational study. Here we present histological and other ndings in 236 cases of clinically suspected post covid fungal infection during 2-month periods. Out of 236 specimens received Result: , 211 showed presence of tissue invasive fungal infection with positivity rate of 89.4%, where male to female ratio was 2.2:1, mean age was 51 years. Most common organism detected was mucor species in 72%, Aspergillus in 4.3% and 23.7% had mixed infection. Angioinvasion was seen in 38.86%. The most common site of involvement was sinonasal (84.36%) followed by orbital (15.16%) and cerebral (0.47%). 68.18% patients were diabetics, 39% had history of moderate to severe covid requiring oxygen, 72.7% had received steroid. Conclusion: Diabetes mellitus and rampant use of corticosteroid in a background of Covid-19 appears to increase opportunistic fungal infection. Mucor and aspergillus were commonly observed tissue invasive and angioinvasive fungal species.