Acute fulminant mucormycosis triggered by Covid 19 infection in young patient: Case report
Sudhagar Eswaran and colleagues from the Department of ENT, Head and Neck Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India recently studied an interesting case report of a patient with covid 19 infection who developed severe acute fulminant mucormycosis during the treatment for covid 19 infection.
The report has been published in the Indian Journal of Otolaryngology and Head & Neck Surgery.
Mucormycosis is a debilitating opportunistic invasive fungal infection that is often seen in immunocompromised patients. It is observed that there is an upsurge of Rhino Orbito Cerebral Mucormycosis(ROCM) in the Covid 19 pandemic.
Covid 19 infection can result in various opportunistic infections. Altered immune response, associated comorbid conditions like diabetes, prolonged steroid and broad spectrum antibiotics usage with ICU interventions lead to increased chance of such superadded infections in covid 19 patients.
The researchers reviewed a 31 year old male patient with covid 19 infection who had new onset Diabetes Mellitus. As per the clinical examination, the patient presented with severe headache, nasal obstruction and discharge, bilateral ophthalmoplegia and blindness with Cavernous Sinus Thrombosis. Patient underwent aggressive surgical debridement with frontal craniectomy, maxillectomy and right orbital evisceration and left endoscopic orbital decompression and judicious efforts to revert back the immunocompromised status with high dose of Liposomal amphotericin.
Post operatively patient developed right temporal lobe abscess which was drained through Endonasal Endoscopic Trans Cavernous drainage of Temporal Lobe Abscess.
Patient in 2 months follow up, has been observed with bilateral blindness and tolerating oral feeds with improved left eye ophthalmoplegia.
Hence, this led the authors to conclude that "it is imperative to note that the rising trend of mucormycosis is there in Covid 19 infections and it should be dealt with high index of suspicion in high risk patients and early aggressive treatment can save the patient as the survival rate is not high in such infections."