Mucormycosis at a tertiary care centre in Gujarat, India

Abstract

The prevalence of mucormycosis is reportedly high in India, although the studies are mainly from north and south India only. We analysed the mucormycosis cases at tertiary care centres of West India. We retrieved the clinical details of all the patients with probable and proven mucormycosis diagnosed at Sterling Hospital and ID clinic at Ahmedabad, Gujarat over the period from 1 January 2013 through 30 April 2015. The data were analysed to determine demography, risk factors, underlying diseases, site of infection and outcome of these patients. A total of 27 patients with the median age of 50 (16-65) years were diagnosed with mucormycosis during the period. Rhino-orbital-cerebral mucormycosis was the most common (51.9%) presentation. Majority (55.6%) of the patients had uncontrolled diabetes with or without ketoacidosis; 25.9% patients had no underlying disease and most of them (85.7%) had cutaneous mucormycosis. In this group, the mortality was 25.9% and an equal percentage of patients were lost to follow up; 14 (51.9%) patients could complete 6 weeks of amphotericin B therapy. All patients who completed antifungal therapy survived except one. Like other parts of India, uncontrolled diabetes was the predominant risk factor for mucormycosis in our group. Patients completing 6 weeks of amphotericin B treatment were likely to survive.

A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India

“…The probable reasons include a delay in diagnosis and the high cost of managing mucormycosis. Many single-centre studies suggest that the epidemiology of mucormycosis is different in India compared with the developed world [3,8,12,13]. However, the existing data are from small studies, and there is a lack of a prospective, multicentre data on mucormycosis from developing countries.…”

Rhinocerebral mucormycosis, risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz, Iran 2007‐2017

“…Mucormycosis is diagnosed based on clinical and histopathological criteria. Recently, molecular techniques have been used for the diagnosis of mucormycosis in tissue samples . Identification of a GRP67 receptor and the necessity of its presence for the virulence of Mucor species and its regulation by iron and hyperglycaemia have significant advances in research on mucormycosis …”

One Health aspects & priority roadmap for fungal diseases : A mini-review

“…Gastrointestinal mucormycosis is transmitted by ingestion of the spores contaminating various foods and beverages. Renal mucormycosis, which is rarely described outside of India, is likely to be caused by the inhalation of spores which disseminate hematogenously to the kidneys or through invasive procedures of the urinary tract 41 42 . In a recent multi-centre study of mucormycosis from India 56.8 per cent of the total 303 patients with mucormycosis had underlying diabetes mellitus and 31 per cent had diabetic ketoacidosis.…”