Abstract

An Analysis of the Presentations of Rhino-Orbital Mucormycosis Amidst the COVID Pandemic: A Case Series Report

Mucormycosis infection is caused by a group of filamentous molds belonging to the order Mucorales. Source of infection maybe inhalation of spores, contaminated food or inoculation into cut skin or open wounds. In developed countries, mucormycosis occurs primarily in severely immunocompromised hosts (e.g. those with hematological malignancies, organ transplantation, neutropenia, autoimmune disorders or other impairments in immunity). More than 100 cases of mucormycosis in people with COVID-19 have been reported, of which 4 of 5 cases were from India and others from the rest of the world. COVID-19 being an immunocompromising condition and steroids being an important part of therapy led to increasing number of cases of rhino-orbital mucormycosis. Our aim is study ocular presentation of the disease amidst COVID-19 peak.

Materials and methods: COVID-19 patients (primary and referral) of rhino-orbital mucormycosis reaching a tertiary health care institute of Ahmedabad were diagnosed via clinical microbiological and radiological tests and evaluated. Vision, ocular movements and slit lamp bio-microscopy of conscious ambulatory patients, bed side examination of critical patients and detailed retinal evaluation of all the patients was done. Systemic comorbidities were noted and diabetic profile was done.

Results and conclusions: Following findings were noted: Lid edema (n=30, 100%), profound vision loss (n=21, 73.33%), ophthalmoplegia (n=26, 86.67%), arterial occlusion (n=16, 60%), Ptosis (n=16, 60%), chemosis (=16, 60%), proptosis (n=16, 60%), Congestion (n=9, 33.33%). Thus, these are the signs to look out for in patients admitted for COVID-19 disease.

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