Mucormycosis and COVID-19: manifestations of the central nervous system and the ocular system

Martínez, Michelle Polo; Jiménez, Rita Fernanda Campo; Castrillón-Lozano, Jorge Andrés

doi:10.1177/20499361221084844

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…In a recent systematic review, an 80% mortality was seen with central nervous system (CNS) involvement. 22 Among the patients who have survived, debridement was performed for minimal or early invasion to the dura and brain. The overall better outcomes in our study can be attributed to early disease detection, prompt surgical debridement, prolonged amphotericin B administration, and strict management of comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone

Mehta¹,

Rao²,

Nagarkar³

et al. 2022

Rambam Maimonides Med J

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Introduction: The second wave of coronavirus disease 2019 (COVID-19) led to the resurgence of opportunistic infections due to the injudicious use of steroids. Sinonasal mucormycosis was declared an epidemic in India during the pandemic. Mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Currently, a resurgence of mucormycosis following initial treatment, in the form of fungal osteomyelitis of the frontal bone, is being seen in India. Methods: This prospective study included 10 patients with fungal osteomyelitis of the frontal bone due to mucormycosis. All patients underwent surgical debridement of the sequestrum and involucrum, with systemic antifungal pharmacotherapy. Results: The average duration of time until mucormycosis recurrence was 22 days following initial treatment (range 10–33 days). Patients presented with extracranial bossing following outer frontal cortex erosion (n=3), bicortical erosion (n=3), bifrontal involvement (n=2), dural involvement (n=3), and involvement of the brain parenchyma and prefrontal cortex (n=2). All cases underwent debridement of the entire sequestrous bone and involucrum until normal bone could be identified. The mean admission duration was 4 weeks (range 3–6 weeks). All treated patients are currently alive and without disease, confirmed by contrast-enhanced computed tomography. Conclusion: Based on our experience, the successful treatment of fungal osteomyelitis due to mucormycosis requires a four-pronged approach: early detection, multidisciplinary management of comorbidities, surgical debridement of necrotic bone, and adequate systemic antifungal therapy.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone

Mehta¹,

Rao²,

Nagarkar³

et al. 2022

Rambam Maimonides Med J

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“…The hot spot in ectomycorrhizae is concentrated over the keywords related to fungi, but no evidence of mucormycosis research was reported in the study (Jiang and Yanbin, 2018). During the COVID-19 pandemic, the pathogenesis shows that mucormycosis also impacted the central nervous system and ocular system (Polo Martínez et al, 2022). So, a study involving another disease, "fungal keratis" reveals that most of co-citation research is concentrated on the disease's epidemiology in and around keratomycosis.…”

Section: Literature Reviewmentioning

confidence: 97%

Mucormycosis Research: A global outlook through bibliometric approaches

Ram

Sharma

Kumar

2023

Iberoamerican Journal of Science Measurement and Communication

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Objective. Mucormycosis is a fungal infection in humans where the causative pathogens belong to the order of Mucorales. The fungal pathogens are also known as black fungi based on morphological characteristics. Mucormycosis is increasingly observed in patients suffering from the COVID-19 virus from different states of India, wherein steroids are being used as standard therapy. The prevalence of coronavirus disease and the infection by the black fungus (Mucormycosis) poses several challenges to its mitigation. The purpose of the study is to analyze the research trends of mucormycosis using bibliometric methods. Design/Methodology/approach. The study utilizes standard bibliometric methods to analyze bibliographic literature on Mucormycosis retrieved from the SCOPUS database. All keywords (MeSH terms) associated with Mucormycosis were used to frame a search query and retrieve bibliographic data from the database. The bibliometric indicators were used to assess research productivity in mucormycosis for publication growth; subject distribution; productive authors, institutes, and countries; journals, highly cited articles; and hot spots and research progress based on the keyword analysis. VOSviewer network visualization tools have been used for mapping research. Results/Discussion. The analysis of 25,251 bibliographic records shows exponential growth in literature during seventy years. Though mucormycosis research is spread across the globe, the prevalence of the study is widespread in the South-East Asian region. Author keyword analysis shows that the research focuses on the medical subject and expands into multidisciplinary research areas. Conclusion. Bibliometrics always provides insight into the research progress in any field or topic of study. This study provides insight into research progress in Mucormycosis. The researcher may use the results to analyze different areas of mucormycosis and utilize the key concepts for further research, especially researching better clinical practices and drug developments. Originality/Value. Through this paper, it is quite clear that the appearance of research contribution on mucormycosis coupled with COVID-19 has opened a new direction of research that clinical researchers take up in future research.

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“…The nonspecific symptoms of the disease may cause a delay in diagnosis, and rapid progression is responsible for the high mortality rate of 40%-80%. Hence, early diagnosis remains the most significant challenge and is essential to reduce morbidity and mortality [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Orbital Mucormycosis: Understanding the Deadly Fungus Sweeping the Globe

Farooq¹,

Khan²,

Singh³

et al. 2023

Cureus

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IntroductionMucormycosis (black fungus) is a rare opportunistic fungal infection commonly affecting immunocompromised individuals. There has been a surge in the number of these cases during the second wave of the coronavirus disease 2019 (COVID-19) in India. Mucormycosis has been reported to occur within a week or a few weeks post-recovery from COVID-19. The most common clinical manifestation of mucormycosis is rhino-orbital-cerebral mucormycosis (ROCM). At our tertiary care center, we initiated a prospective study to identify risk factors, study ocular manifestations, and explore medical and surgical management of orbital mucormycosis patients in the post-COVID-19 era. Material and methodsThis is a detailed description of a prospective observational hospital-based study. The study included 148 patients who presented with ROCM. A detailed history was taken regarding the complaint, duration, and associated risk factors. Systemic, local, and complete ophthalmic examinations were done that included assessment of extraocular movements, visual acuity, slit-lamp examination, and fundus examination. All data were recorded separately for each patient in a pre-decided proforma. ResultThe study group consisted of 148 patients. In our study, the highest association was with COVID-19-positive status (68.24%), out of which 57 (56.43%) were on oxygen support. Diabetes mellitus contributed next to COVID-19 with 86 (58.10%) patients with a positive history of diabetes. Seventy-one (47.97%) patients were on steroids, out of which 68 (67.32%) were COVID-19-positive and the rest (23%) were on steroids due to various systemic reasons. Rhinomaxillary involvement was present (51%). Out of 63 patients with orbital involvement, 16 (25.39%) presented bilaterally and 47 showed unilateral orbital involvement more on the right side (42.85%). The predominant location of orbital involvement was the orbital apex. The most common symptom seen in our study was nasal discharge (86.5%), and ophthalmoplegia was the most common sign. ConclusionCorticosteroids should be used with caution to prevent negative impact and potential ROCM. Good glycemic and metabolic control is crucial for treatment. Management of mucormycosis involves surgical debridement, antifungal agents, and retrobulbar amphotericin B injections. Early diagnosis and aggressive treatment are essential for success. Orbital exenteration may be necessary for advanced stages, while conservative approaches may work for earlier stages. Patient counseling is needed for cosmetic rehabilitation. A multidisciplinary approach involving various specialists is necessary.

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Mucormycosis and COVID-19: manifestations of the central nervous system and the ocular system

Cited by 3 publications

References 18 publications

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone

Outcomes of Open Fronto-Facial Resection for Fungal Osteomyelitis of Frontal Bone

Mucormycosis Research: A global outlook through bibliometric approaches

Orbital Mucormycosis: Understanding the Deadly Fungus Sweeping the Globe

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