Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Rao, Raksha; Shetty, Adheesh P; Nagesh, Chinmay

doi:10.4103/ijo.ijo_1053_21

Cited by 47 publications

(25 citation statements)

References 16 publications

(50 reference statements)

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“…The papers (case reports and case series) reported 100 patients including present case report ( Table 1 ) [ [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] ]. The majority of the patients were presented from India (7 case reports and 5 case series, a total of 68, 68%), followed by Turkey (12), USA (9), Iran (3), Spain (2), United Kingdom (1), Brasil (1), Italy (1), France (1), Mexico (1), and Austria (1).…”

Section: Resultsmentioning

confidence: 99%

COVID-19-associated mucormycosis: Case report and systematic review

Dilek

Özaras²,

Özkaya

et al. 2021

Travel Medicine and Infectious Disease

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Section: Resultsmentioning

confidence: 99%

COVID-19-associated mucormycosis: Case report and systematic review

Dilek

Özaras²,

Özkaya

et al. 2021

Travel Medicine and Infectious Disease

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“… Pauli et al (2021), Brazil [ 50 ] Retrospective, case report, single centre 50 0 (0) Diabetes NA No Uncontrolled diabetes Yes Definite Ulcerated lesion with coagulative necrosis, hemorrhage, and abundant neutrophils Palatal ulcer/Mucorale (unspecified) Placik et al (2020), United States [ 51 ] Retrospective, case report, single centre 49 1 (100) None Yes Yes Steroid for SARS-CoV-2 Yes Definite Right pneumothorax, bronchopulmonary fistula, necrotic empyema Pulmonary mucormycosis/ Rhizopus spp. Rao et al (2021), India [ 34 ] Retrospective, case report, single centre 66 1 (100) Diabetes No Yes Uncontrolled diabetes, steroid for SARS-CoV-2 Yes Definite Periorbital pain followed by sudden onset of vision loss in the left eye Rhino‑orbital mucormycosis/Mucorale (unspecified) Ravani et al (2021), India [ 35 ] Retrospective, case series, single centre Mean, 56.3 NA Diabetes ( n = 19); plus, other comorbidities (hypertension/ischemic heart disease/kidney disease) NA Yes Uncontrolled diabetes, steroid for SARS-CoV-2 NA NA The most common presentation was diminution of vision (< 6/60 in 80.64% patients) and ophthalmoplegia (77.4%). The most common imaging findings were orbital cellulitis (61.29%) and pansinusitis (77.4%) …”

Section: Discussionmentioning

confidence: 99%

COVID-19 and mucormycosis superinfection: the perfect storm

et al. 2021

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Background The recent emergence of the Coronavirus Disease (COVID-19) disease had been associated with reports of fungal infections such as aspergillosis and mucormycosis especially among critically ill patients treated with steroids. The recent surge in cases of COVID-19 in India during the second wave of the pandemic had been associated with increased reporting of invasive mucormycosis post COVID-19. There are multiple case reports and case series describing mucormycosis in COVID-19. Purpose In this review, we included most recent reported case reports and case-series of mucormycosis among patients with COVID-19 and describe the clinical features and outcome. Results Many of the mucormycosis reports were eported from India, especially in COVID-19 patients who were treated and recovered patients. The most commonly reported infection sites were rhino-orbital/rhino-cerebral mucormycosis. Those patients were diabetic and had corticosteroids therapy for controlling the severity of COVID-19, leading to a higher fatality in such cases and complicating the pandemic scenario. The triad of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), corticosteroid use and uncontrolled diabetes mellitus have been evident for significant increase in the incidence of angioinvasive maxillofacial mucormycosis. In addition, the presence of spores and other factors might play a role as well. Conclusion With the ongoing COVID-19 pandemic and increasing number of critically ill patients infected with SARS-CoV-2, it is important to develop a risk-based approach for patients at risk of mucormycosis based on the epidemiological burden of mucormycosis, prevalence of diabetes mellitus, COVID-19 disease severity and use of immune modulating agents including the combined use of corticosteroids and immunosuppressive agents in patients with cancer and transplants.

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“…On analyzing the sources of the reported cases, India was the most contributing country (55.5%) [46][47][48][49][50]58,69,77,[80][81][82][84][85][86][87][88], followed by Egypt (17.8%) [72,74], Iran (9.9%) [63,64,70,78], Turkey (6.3%) [65,71], and the United States of America (4.7%) [52][53][54][55][56][57]59,75,76]. See Figure 4.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

Riad

Shabaan

Issa

et al. 2021

JoF

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Background: Since the novel coronavirus disease (COVID-19) outbreak, the cases of COVID-19 co-infections have been increasingly reported worldwide. Mucormycosis, an opportunistic fungal infection caused by members of the Mucorales order, had been frequently isolated in severely and critically ill COVID-19 patients. Methods: Initially, the anamnestic, clinical, and paraclinical features of seven COVID-19-associated mucormycosis (CAM) cases from Egypt were thoroughly reported. Subsequently, an extensive review of the literature was carried out to describe the characteristics of CAM cases globally, aiming to explore the potential risk factors of mortality in CAM patients. Results: Out of the seven reported patients in the case series, five (71.4%) were males, six (85.7%) had diabetes mellitus, and three (42.9%) had cardiovascular disease. All patients exhibited various forms of facial deformities under the computed tomography scanning, and two of them tested positive for Mucorales using the polymerase chain reaction (PCR) testing. Liposomal amphotericin B (LAmB) was prescribed to all cases, and none of them died until the end of the follow-up. On reviewing the literature, 191 cases were reported worldwide, of which 74.4% were males, 83.2% were from low-middle income countries, and 51.4% were aged 55 years old or below. Diabetes mellitus (79.1%), chronic hypertension (30%), and renal disease/failure (13.6%) were the most common medical comorbidities, while steroids (64.5%) were the most frequently prescribed medication for COVID-19, followed by Remdesivir (18.2%), antibiotics (12.7%), and Tocilizumab (5.5%). Conclusions: As the majority of the included studies were observational studies, the obtained evidence needs to be interpreted carefully. Diabetes, steroids, and Remdesivir were not associated with increased mortality risk, thus confirming that steroids used to manage severe and critical COVID-19 patients should not be discontinued. Lung involvement, bilateral manifestation, and Rhizopus isolation were associated with increased mortality risk, thus confirming that proactive screening is imperative, especially for critically ill patients. Finally, surgical management and antimycotic medications, e.g., amphotericin B and posaconazole, were associated with decreased mortality risk, thus confirming their effectiveness.

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Orbital infarction syndrome secondary to rhino-orbital mucormycosis in a case of COVID-19: Clinico-radiological features

Cited by 47 publications

References 16 publications

COVID-19-associated mucormycosis: Case report and systematic review

COVID-19-associated mucormycosis: Case report and systematic review

COVID-19 and mucormycosis superinfection: the perfect storm

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

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