Mucormycosis - An Adamant Parasitic Fungal Infection Requiring Multiple Surgeries

Abstract

Introduction - Mucormycosis is a life threatening invasive fungal infection that mostly occurs in immunocompromised patients. Aim of our study is to analyze the management of mucormycosis in rhinoorbital mucormycosis cases and dire requirement for more than one surgical intervention for their management. The limitations of first surgery, progressive nature of disease, and difficult anatomical regions were the areas to address in most of our patients in this series. Methodology - Our case series consists of 34 confirmed cases of mucormycosis using standard staining and histopathological confirmation on biopsy. The study group being subjected to complete modern diagnostic, CT, MRI scrutinization. Detailed follow up with serial endoscopies, post-surgery. Re confirmation of residual on progressive mucormycosis disease condition being subjected to repeat of these investigative tools and confirmation with PET scan. Results – Total of 34 patients were included in our study majority of them were diabetic. Only 3 patients underwent single stage debridement however 34 patients underwent debridement in two successive stage and two patients required third surgery for disease clearance. Conclusion – Repeated surgical debridement is must for complete disease eradication in case of rhinoorbitocerebral mucormycosis. Also, medical management can prolong the survival of patients with disease in areas which are inaccessible by surgical clearance. Serial radiography with CT, MRI and PET scan are not only contributary but mandatory.