Study Of Clinical, Labarotary And Imaging Profiles Of Patients With Mucormycosis: A Retrospective Study

Abstract

Background: Rhino-orbital-cerebral mucormycosis is an invasive fungal infection The fungal order Mucorales consists of seven families that are known to cause mucormycosis [1]. Rhizopus oryzae and R. delemar (both in the family Mucoraceae) are by far the most common causes of mucormycosis. It is a rare but potentially life-threatening infection associated most commonly with uncontrolled diabetes mellitus, diabetic ketoacidosis and immunocompromised states. The annual incidence of mucormycosis is estimated to be around140 cases per 1,000,000 in India. The pandemic brought along with it a raging havoc in the form of disseminated mucormycosis infection

Methods: This was a single centre hospital-based retrospective observational time bound study conducted in subjects admitted to our institute over a period of 36 months from January 2021 to December 2023. SARS CoV-2 PCR test and CT paranasal sinus(PNS) were carried out on patients with mucormycosis.

Results: Of total 44 patients with mucormycosis, 31 (70.40%) were males and 13 (29.54) were females diagnosed to have mucormycosis during the study period. Males were outnumbered as compared to females amongst the study population.

The mean age for the patient was 49.52 (+/- 12.95)

Total 31 patients (70.40%) had Type 2 Diabetes mellitus. Total 12 patients had Hypertension (27.27%). Total 22 (50%) had COVID 19 and presented in 2020 and 2021. COVID-19-associated mucormycosis (CAM) surged during the pandemic in India, with multiple studies linking the outbreak to high-dose steroid use and poorly controlled diabetes [9,10].

Of total 44 patients with mucormycosis, 24 (54.54%) had underwent operative intervention in the form of functional endoscopic sinus surgery.

A total of 7 (15.90%) patients had pulmonary complications and 5 (11.36%) had cerebral/cortical venous sinus thrombosis. Of them 1 (20%) had Cavernous venous Sinus Thrombosis .

A total 9 (20.45%) patients had laboratory evidences of acute kidney Injury. A total 23 (52.27%) had Maxillary Sinus with intracranial involvement.

Conclusion: In the present study we observed that conventional risk factors like uncontrolled diabetes mellitus with or without ketoacidosis added by COVID-19 disease and steroid intake directly affected the incidence of occurrence of mucormycosis.