DISCRIPTIVE STUDY OF MUCORMYCOSIS AND COVID 19 IN TERCIARY CARE CENTRE , THANJAVUR, INDIA.

Abstract

Introduction: Corona virus disease 2019 (COVID-19) infection and its associated Bacterial and Fungal infections are more in number in this Second Wave. Among them the Mucormycosis is more in number in Post COVID-19 and during treatment of COVID-19 . Increased incidence related with usage of Steroids and Oxygen in the management of Covid19. Early Endoscopic Debridement and Inj. Amphotericin plays major role. Objectives: Study about the various Types of Mucormycosis, Iinvolvement of various Para Nasal Sinuses, Orbital involvement and its association with Steroid Usage, Oxygen Theraphy and Diabetes Mellitus and Effectiveness of Earlier Surgical Debridement. Study Design: Discriptive Study, Analytical Study. Materials And Methods: Study was conducted in Government Thanjavur Medical College, Tamil Nadu, India in MucorMycosis ward and ENT Department from May 2021 - July 2021. Total Number of patients are 241. . All cases are Evaluated, Processed, and Classied into various types. Rhino-Orbital type of cases are taken for Endoscopic Sinus Surgery followed by Amphotericin injection and discharged and followed regularly. Results: Mucormycosis of Nose and Paranasal Sinus involvement are more in numbers, followed by Rhino –Orbital Mucormycosis, and RhinoCerebral types. Pulmonary, Cutaneous and Intestinal MucorMycosis are very few only. Males are more affected. Most of the cases associated with Diabetes. Excellent Recovery and Reduced Recurrence in Earlier Surgical Debridement cases than later cases. Discussion: Sino Nasal type of Mucormycosis are more in number. Very early Diagnosis with Suspicious Clinical Symptoms and Signs and Supportive Evidence by Radiological investigation especially by MRI is very important. Earlier Surgery and Adequate Amphotericin coverage plays vital role. HPE and Fungal Culture is Essential. Glycemic Control is Mandatory for Good Results. Steroid use and Oxygen theraphy are not having Signicant relationin development of Mucor in our study. Regular weekly Follow-up, Endo- Clearance, Nasal Douching with Hypertonic Saline and Solvage theraphy with Tablet Posaconazole, and Diabetes Management Signicantly reduces the Recurrence. Conclusion: Earlier Diagnosis and Effective Surgical Debridement and Adequate Antifungal treatment and Good Glycemic Control is the Mainstay of Mucormycosis Mangement. Regular Follow-up is necessary for Reduction of Recurrence.