Post Covid Jaw Osteomyelitis With Mucormycosis - An Institutional Study

Abstract

Mucoraceae are ubiquitous fungi and are found in, soil, air, contaminated water and hospital environments too. These fungi usually gain entry into host through respiratory tract and sinuses either by direct spread or by angioinvasion. Major sites of infection are sinuses, lungs, skin, brain, and gastrointestinal tract. From sinus it may invade maxilla causing osteomyelitis of jaw. Mucormycosis is an opportunistic infection and the major risk factors include poorly controlled diabetes mellitus (DM), iron overload, prolonged corticosteroid use and immunocompromised status. CORONA virus disease 2019 (Covid-19) is an infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The majority of patients have a good prognosis, but some patients become critically ill and even deaths occur. Disease itself decreases cell mediated immunity and increases iron load in covid patients. For treatment of Covid-19 corticosteroids, antiviral drugs and immunomodulatory drugs are being used. Steroid reduces inflammation in covid 19 patients, but it pushes up the blood sugar which causes ketoacidosis, increases iron load, affects cell mediated immunity and favours the mucor mycosis growth. So, there are reported increasing cases of mucormycosis in post COVID-19 patients. Present study includes 25 reported cases of mucormycosis with jaw osteomyelitis in post covid patients with respect to clinical characteristics, past medical history, comorbidities medication received during covid 19, radiographic feature, lab diagnostic methods, histopathological reports, and treatment. So as to gain an insight of this disease as early diagnosis of mucor mycosis and treatment which can significantly reduce the mortality and morbidity of mucormycosis patients