Mucormycosis In Adult Patients
- Mucormycosis or Zygomycosis is a fungal disease caused by fungi of order Mucorales.
- High risk group- Diabetes mellitus, diabetic ketoacidosis, steroid, cytotoxic drug therapy, HIV, immunosuppression, malignancy or haematological disorder including iron overload states.
- New corona virus SARS COV 2 itself may serve as a risk factor – chronic respiratory disease, corticosteroid therapy, intubation /mechanical ventilation, deranged glucose metabolism, which may lead to secondary fungal infection.
- Facial findings
Facial swelling / Paresthesia / Discolouration of skin (necrosis)/ Infection in dangerous area of face
- Nasal findings:
Foul smelling nasal discharge/Nasal congestion/ Sinusitis/ Erythematous to violaceous to black necrotic eschar in nasal cavity
- Intraoral findings:
Halitosis/ Intraoral pus discharge/ Ulceration & Blackening of mucosa/ Exposed palatal bone/Loosening of teeth/ Unhealed tooth socket/ Mobility of maxilla
- Orbital findings:
Vision loss/ Peri orbital cellulitis/ Chemosis/ Exophthalmos(Proptosis)/ Opthalmoplegia
Specific points to be observed in history:
- H/o COVID infection (Immunosuppressive drugs/ Ventilatory care, etc.)
- Co morbid conditions: Diabetes mellitus/ Malignancy/ HIV/ Chronic kidney disease / Obesity/ Other systemic illness
- Local factors (H/O tooth extraction or any other oral/surgical procedure/ Head injury)
- Lab parameters:
- Nasal endoscopic examination:
Black necrotic eschar tissue
- Radiographic Examination
Contrast enhanced CT scan with 3D Reconstruction findings:
- MRI with contrast findings.
- Fungal culture