A comprehensive review of pathogenesis of mucormycosis with implications of COVID-19: Indian perspective

Abstract

Mucormycosis is a deadly fungal infection that targets immunocompromised individuals. India being the “diabetes” capital of the world contributes to about 40% of global burden of the infectious disease. With the addition of COVID-19 pandemic to the equation, there has been an alarming increase in the number of reported cases of mucormycosis. The disease itself along with corticosteroid and certain other strategies used in its treatment predispose the patients to develop secondary bacterial and fungal infections. Therefore, it is imperative for clinicians to understand the pathogenesis of mucormycosis at present so that they can develop combative counter strategies. We provide a comprehensive review of the pathogenetic process of mucormycosis while also elucidating implications of COVID-19 pandemic in the epidemiology and pathogenesis of the infectious malice in an Indian background.

Is post-COVID osteonecrosis of jaw (PCONJ) Masquerading as osteomyelitis ? A largest unicentric report of 13 cases

“…Within a few weeks’ time a dramatic rise in cases of Mucormycosis especially with the rhinomaxillary involvement was seen across many centres [ 2 ]. Patients with history of hospitalization due to COVID-19 were the victims and the increased incidence of the disease was attributed to treatment of COVID-19 by steroids and pre-existing or newly diagnosed diabetes coupled with vascular damage caused by the virus itself [ 8 , 9 ]. As time passed by, the mucormycosis cases began to decline and we started witnessing cases of aseptic osteonecrosis of the jawbones related to COVID-19 and so did we (Supplementary File).…”

Prosthetic rehabilitation of a patient with COVID-associated mucormycosis

“…7 India is the diabetes capital on the global scale and therefore, it already had a higher prevalence of mucormycosis. 3 The initiation of steroid therapy in COVID-19-infected patients coupled with the cytokine storm caused by the disease, further accentuated the prevalence of mucormycosis. 6 Likewise, in the present case, the patient contracted Mucormycosis infection after getting treated for COVID-19 and was treated for the same.…”

“…The predisposing factors for the development of the dreadful fungal infection include diabetes mellitus with or without keto-acidosis, hematological or other malignancies, transplantation, iron overload, corticosteroid use, trauma, prolonged neutropenia, and malnutrition. 3 The treatment includes control of metabolic diseases, antifungal medications, and surgical resection of affected tissues. 4 Surgery majorly involves the radical removal of the infected areas followed by prosthetic replacement.…”