Profile of rhino-orbital-cerebral mucormycosis at a tertiary care center in Dehradun

Abstract

Aims of this study to determine the predisposing factors and common presenting complaints of ROCM patients, the knowledge of which will assist in formulation of effective preventive measures at our local level. A retrospective, hospital record-based study was conducted comprising 30 patients that presented to our tertiary care centre from 1st February to 31st July, 2021, admitted under a Multidisciplinary mucormycosis team. Detailed history and examination was supplemented with histopathological and radiological investigations. Preponderance for middle aged to elderly was seen. Only one patient had bilateral presentation. Diabetes mellitus was found to be the primary associated comorbidity. Duration of COVID infection emerged as a significant factor with 70% of cases observed to have a duration > 28 days. Primary presenting complaint was facial edema followed by proptosis and Diminution of vision. Corticosteroid use was the prevailing predisposing factor. All patients received parenteral therapy with Amphotericin B. Of the 30 cases, 76.67% required primary functional endoscopic debridement, and four reported mortality as the final outcome. 10% patients required re-debridement with retrobulbar amphotericin B injection, and only two ended in Orbital exenteration. High index of clinical suspicion in elderly and diabetics especially in corticosteroids and/or oxygen therapy is required. Due attention to warning symptoms and signs, early diagnosis and apt treatment may help optimize the outcome of ROCM in the setting of COVID-19.