International Journal of Medical Laboratory Research (IJMLR)

AN EPIDEMIC IN A PANDEMIC: EMERGENCE OF MUCORMYCOSIS POST COVID-19 RECOVERY- CASE SERIES ON A MULTI DISCIPLINARY APPROACH

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M Srivastava, A Kumar , H Kaur, I Sharma,S Rukwal, M Chaudhry 

 

ABSTRACT: INTRODUCTION: Mucor mycosis is an Angio invasive mycosis with high morbidity and mortality rates that predominantly occurs in immunocompromised patients. It is commonly reported in immunocompromised patients such as those suffering from uncontrolled diabetes mellitus, blood dyscrasias, malnutrition, neutropenia, iron overload, organ transplant, and immunosuppressive therapy. Diagnosis of Mucor mycosis is made by performing Rapid fungal stains, fungal culture and Histopathological examination of the biopsy / nasal scrapings obtained from the affected site. CASE PRESENTATION: We have reported seventeen (17) cases of Mucor mycosis at our hospital in the past 25 days which is between 10/05/2021- 04/06/2021. Out of Out of these seventeen (17) cases, fourteen (14) cases were affecting only the paranasal sinuses causing Acute Invasive Fungal Sinusitis. Three (3) were diagnosed as Rhino- Orbital type. Among the three Rhino-orbital cases, two (2) were Rhino-Orbito- cerebral type (ROCM). Unfortunately, one (1) case succumbed while rest others are undergoing treatment. DISCUSSION: A common observation found among all was rampant use of steroids for treating COVID-19 disease and poor glycemic control. Majority of patients were either known diabetic or were diagnosed with Diabetes Mellitus during the course of their current illness. CONCLUSION: COVID-19 causes Mucor mycosis through multiple mechanisms. COVID-19 causes alteration of iron metabolism leading to " Hyper ferritinemic syndrome" which provides free iron in circulation favoring growth of mucor. Also autopsies conducted indicated widespread severe vascular endothelial injury in COVID-19 than patients died of influenza A, H1N1.

 

KEY WORDS: Covid-19, Mucormycosis, Pandemic, H1N1

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