Central retinal artery occlusion as the presenting manifestation of invasive rhino-orbital-cerebral mucormycosis

Bawankar, Pritam; Lahane, Sayalee; Pathak, Pooja; Gonde, Payal P.; Singh, Anjali

doi:10.4103/tjo.tjo_72_18

Cited by 35 publications

(34 citation statements)

References 10 publications

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“…The progression of the disease from nose and sinuses is either direct or through vascular occlusion. Intracranial involvement also occurs by invasion through superior orbital fissure, ophthalmic vessels, cribriform plate [ 18 ], carotid artery or possibly via a perineural route [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Sino-orbital mucormycosis in a COVID-19 patient: A case report

Maini

Tomar

Khanna

et al. 2021

International Journal of Surgery Case Reports

155

126

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Introduction We report a case of post COVID-19 Sino-orbital Mucormycosis infection caused by Rhizopus oryzae and its management. Presentation of case The patient was diagnosed with COVID-19 and treated according to the persisting protocols. Following recovery, on the 18th day, the patient developed chemosis and pain in the left eye. A diagnosis of mucormycosis was established after Magnetic Resonance Imaging (MRI) and Functional Endoscopic Sinus Surgery (FESS). Initially, conservative management with intravenous (IV) Fluconazole & Amphotericin B was done and later on with surgical debridement. The patient recovered with minimal residual deformity. Discussion Mucormycosis generally develops secondary to immunosuppression or debilitating diseases. In Head and Neck cases, the mold usually gains entry through the respiratory tract involving the nose and sinuses, with possible further progression into the orbital and intracranial structures. Hence, an early diagnosis and intervention is required for a good prognosis, decreasing the morbidity. This can be achieved on the basis of clinical picture and direct smears. Conclusion Research needs to be carried out in COVID-19 patients for better prevention and management of opportunistic infections in order to reduce its incidence and morbidity. Prophylactic treatment protocols need to be established, along with rational use of corticosteroids.

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Section: Discussionmentioning

confidence: 99%

Sino-orbital mucormycosis in a COVID-19 patient: A case report

Maini

Tomar

Khanna

et al. 2021

International Journal of Surgery Case Reports

155

126

View full text Add to dashboard Cite

show abstract

“…This highlights the paramount importance of development of new antimycotics, and further development of existing onesparticularly considering the life-threatening fungal infections treated in intensive care units, regardless of whether COVID-19 infections are involved. Such agents could also be useful in treating fungal endophthalmitis as well as potentially life-threatening mucormycoses [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Weiterentwicklungen dieser Substanzen äußerst wichtigbesonders für lebensbedrohliche Pilzinfektionen auf den Intensivstationen, nicht nur zu COVID-19-Zeiten. Auch bei der Keratomykose sowie der Pilzendophthalmitis könnten sie Bedeutung erlangen und ebenso bei der bedrohlichen Mukormykose [6,7].Die folgenden Substanzen sind derzeit noch nicht auf dem Markt. In komplizierten, mit hochdosierten herkömmlichen Anti-mykotika nicht zu beherrschenden Pilzinfektionen kann es aber sinnvoll und hilfreich sein, mit dem Hersteller Kontakt aufzunehmen.…”

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New Antimycotics in the Pipeline – For Ophthalmology Too?

Behrens–Baumann

2021

Klin Monbl Augenheilkd

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Seven new antimycotics are presented that are at different points of development or approval. These substances are mainly first-in-class drugs. They are primarily developed for systemic administration. However, with the support of a pharmacist, the intravenous formulation may be used as eyedrops. In this short review, the activities of the substances against various fungal infections are described. After unsuccessful conventional therapy of fungal eye infections, one of these new substances might be suitable to cure the mycosis.

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“…The progression of the disease from the nose and sinuses is either direct or through vascular invasion. Intracranial involvement may also occur by invasion through the superior orbital fissure, ophthalmic vessels, cribriform plate, and carotid artery or via the perineural route [ 11 , 12 ]. The diagnosis of this disease entity should be based on the clinical features with the support of microbiological and radiological findings [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Early Surgical Intervention Followed by Antifungals in Rhino-Orbital Mucormycosis in Patients With COVID-19 Favors Clinical Outcome: A Case Series

Roy¹,

Gupta²,

Biswas³

et al. 2021

Cureus

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Mucormycosis is an invasive fungal infection occurring in patients with or without preexisting medical illnesses. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, there have been increasing reports of bacterial and fungal coinfections among some COVID-19 patients with preexisting comorbid illnesses such as diabetes and hypertension, with mucormycosis being one of them. The management of this dreaded fungal infection demands early and prompt surgical intervention to thoroughly remove the infected tissue and necrotic material to reduce the tissue burden of this invasive organism. This should be accompanied by expeditious initiation of amphotericin B along with supportive therapy. Here we present five cases of rhino-orbital mucormycosis in patients with COVID-19, all of whom presented with orbital and facial swelling (three had symptoms of impending blindness) under the backdrop of COVID-19 symptoms in the form of intermittent fever and slight dyspnea. Our treatment strategy comprised an expeditious use of early surgical intervention and amphotericin B along with the control of cytokine storm and hyperglycemia. This treatment strategy eventually resulted in an improved clinical outcome.

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Central retinal artery occlusion as the presenting manifestation of invasive rhino-orbital-cerebral mucormycosis

Cited by 35 publications

References 10 publications

Sino-orbital mucormycosis in a COVID-19 patient: A case report

Sino-orbital mucormycosis in a COVID-19 patient: A case report

New Antimycotics in the Pipeline – For Ophthalmology Too?

Early Surgical Intervention Followed by Antifungals in Rhino-Orbital Mucormycosis in Patients With COVID-19 Favors Clinical Outcome: A Case Series

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