Study of Clinical Profile with Radiological and Histopathological Evaluation of Patients with Orbital Mucormycosis in COVID-19 Era

Author(s): Ekta Agrawal, Saurabh Patil.

Introduction: “Mucor” is a fungus normally found in the environment, mainly in soil. Mucormycosis occurs in patients with compromised immunity like uncontrolled DM, prolonged ICU stay, post organ transplant, patients on anti-cancer drugs, prolonged use of steroids (any dose for >3weeks or high dose >1week), HIV/AIDS, prolonged neutropenia, IV drug abusers, etc. Recently, abrupt rise is being reported in Mucormycosis cases with COVID-19 spread, leading to serious ocular complication like globe proptosis, blurred vision, loss of vision and eye and may be life threatening.

Objective: To study the clinical profile of patients with Orbital Mucormycosis with radiological and histopathological evaluation during covid-19 pandemic.

Methodology: We evaluated the clinical and imaging data of ten patientsseven males and three female, 20 to 65 years old diagnosed of Orbital Mucormycosis. All the patients included in the study had recent history of COVID-19 infection. On evaluating risk factors: 5-diabetes mellitus, 3-prolonged ICU stay, rest 2 were with concomitant immunocompromised state.

Results: All patients included in the study received - IV Dexamethasone for COVID-19 related disease and IV Amphotericin B for Orbital Mucormycosis. Besides that, eight patients received Inj. Remdesivir, and nine patients were on additional Ventilatory support. Within 4-5 weeks of the diagnosis, three patients could not survive, five patients showed satisfactory systemic outcome but with ocular complication of irreversible vision loss, while two patients showed favourable outcome in ocular as well as systemic ailments.

Conclusion: COVID 19 infection recently emerged as a risk factor for Orbital Mucormycosis.