Neurological infections in 2021: a spotlight on India

Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Pandey, Shweta

doi:10.1016/s1474-4422(21)00415-4

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…In CNS there may be involvement of the cavernous sinus (approximately 70% of cases), followed by the cribriform plate (22%) and pterygopalatine fossa (12%). [ 12 ]…”

Section: Methodsmentioning

confidence: 99%

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

Gupta

Gupta²,

Kayarat³

2023

Saudi J Anaesth

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Mucormycosis once considered a rare disease with an incidence of 0.005 to 1.7 per million, has become one of the greatest menaces during the coronavirus disease (COVID-19) pandemic. India alone has contributed to nearly 70% of the global caseload of COVID-associated mucormycosis (CAM) and it had even been declared as a notifiable disease. Second wave of COVID-19 pandemic saw a steep rise in the incidence of mucormycosis and these patients have been presenting to anesthesiologists for various surgical procedures due to its primary or secondary sequelae. Rhino-orbito-cerebral mucormycosis (ROCM) is the commonest manifestation and is caused by Rhizopus arrhizus. Injudicious use of corticosteroids in vulnerable patients could have been a major contributing factor to the sudden rise in ROCM during the pandemic. Concerns related to anesthetic management include COVID-19 infection and post COVID sequalae, common presence of uncontrolled diabetes mellitus, possibility of difficult mask-ventilation and/or intubation, various drug therapy-associated adverse effects, and interaction of these drugs with anesthetic agents. Thorough preoperative optimization, multidisciplinary involvement, perioperative care, and vigilance go a long way in improving overall outcomes in these patients.

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“…In CNS there may be involvement of the cavernous sinus (approximately 70% of cases), followed by the cribriform plate (22%) and pterygopalatine fossa (12%). [ 12 ]…”

Section: Methodsmentioning

confidence: 99%

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

Gupta

Gupta²,

Kayarat³

2023

Saudi J Anaesth

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“…Sphenopalatine fossa serves as a reservoir. CNS invasion may be by direct, hematogenous or transneuronal spread (6). Apart from rhino-orbitalcerebral mucormycosis (ROCM) and pulmonary involvement, cutaneous and gastrointestinal manifestations are also known.…”

Section: Covid-associated Mucormycosis (Cam)mentioning

confidence: 99%

Epidemic of COVID-Associated Mucormycosis in India and a road ahead

Sharma¹,

Sharma²,

Chandra³

et al. 2023

Asian J. Internal Med.

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Epidemic of COVID-Associated Mucormycosis inIndia and a road ahead COVID-associated Mucormycosis (CAM) was a peak-hour crisis in India. The situation arose from an unprecedented ICU workload of critical COVID-19 cases, insufficient resources and the impaired immune status of the patient. We recommend strong preventive measures, chemoprophylaxis and Amphotericin-B nebulisation for the effective management of CAM.

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“…The Indian sub-continent saw an unprecedented rise in invasive fungal rhinosinusitis owing to the Covid-19 virus pandemic (4). Poor glycemic control, steroid therapy, and virus-induced immunological changes were some factors speculated to influence the pathogenesis (5).…”

Section: Introductionmentioning

confidence: 99%

“…The Indian subcontinent saw an unprecedented rise in invasive fungal rhinosinusitis owing to the coronavirus disease 2019 (COVID-19) pandemic. 4 Poor glycemic control, steroid therapy, and virus-induced immunological changes were some factors speculated to influence the pathogenesis. 5 The most common pathogen encountered was the Mucorales species, followed by Aspergillus.…”

Section: Introductionmentioning

confidence: 99%

Changing Spectrum of Invasive Fungal Infections of the Anterior Skull Base

Bhuskute

Keshri

Seduchidambaram

et al. 2023

J Neurol Surg B Skull Base

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Objective To study the evolving pathophysiology and symptomatology of invasive fungal rhinosinusitis affecting the skull base. Design Retrospective clinical study Setting Single-Centre Materials and Methods: All cases of invasive fungal rhinosinusitis with clinico-radiological and/or operative evidence of anterior and central skull base, orbit, and orbital apex involvement with or without intracranial disease were included in the study. We assessed the risk factors such as COVID 19 infection, diabetes mellitus and radiological features and management strategy Results: There were 79 patients, of which 65.8% had skull base ROCM, and 34.2% had invasive aspergillosis. The mean duration of onset of the disease was 36.75±20.97 days in ROCM with the majority of patients (66%) presenting after 30 days of symptoms. In the Invasive aspergillosis group, the median presentation duration after symptom onset was 21 weeks. In 40.8% of patients, tissue diagnosis was unavailable, and galactomannan assay and clinico-radiological assessment were used for diagnosis. The most common area of the skull base was the pterygopalatine fossa (88.5%). The most common Neural structure involved was the pterygopalatine ganglion. Conclusion: With the increasing incidence of invasive fungal infections worldwide, particularly after the Covid- 19 pandemic, it is crucial to understand the evolving nature of this disease. ROCM, documented in the literature to cause fulminant disease, became a chronic illness, possibly due to the improvement of the patient's immunity during the disease course.

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Neurological infections in 2021: a spotlight on India

Cited by 3 publications

References 10 publications

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

Epidemic of COVID-Associated Mucormycosis in India and a road ahead

Changing Spectrum of Invasive Fungal Infections of the Anterior Skull Base

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