Ocular Manifestations of MUCORMYCOSIS in patients of COVID-19

Abstract

Mucormycosis is an angioinvasive disease caused by fungi of the order Mucorales like Rhizopus, Mucor, Rhizomucor, Cunninghamella and Absidia. The prevalence of mucormycosis in India is approximately 0.14 cases per 1000 population, about 80 times the prevalence in developed countries. Mucormycosis is a potentially fatal opportunistic infection that can manifest in many clinical forms, including a rhinocerebral form, in the pulmonary system, central nervous system, gastrointestinal system, and other body parts. Rhinocerebral mucormycosis is subdivided into 3 groups: rhinomaxillary, rhino-orbital, and rhino-orbito-cerebral mucormycosis. Extensive forms of the disease include ophthalmia and cranial nerve involvement. Mucormycosis is often seen in immunocompromised individuals, and complications of orbital and cerebral involvement are likely in diabetic ketoacidosis and with the concomitant use of steroids. The most common risk factor associated with mucormycosis is diabetes mellitus in India. Hence, early diagnosis of this potentially life-threatening disease and prompt treatment are important in reducing the mortality rate. Recently, several cases of mucormycosis in people with COVID-19 have been increasingly reported worldwide, particularly in India. We currently report 4 cases of clinically diagnosed orbital mucormycosis with concurrent COVID-19 illness at our institute over the last 2 months (May and June 2021).