ABSTRACT
Objective: To analyse demographic data, provide an overview of the diverse clinico-radiological presentations of cerebral abscess in post covid ROCM. Background: The vulnerability of COVID-19 patients to ROCM, a spectrum of limited sinonasal, rhino-orbital and rhino-orbital-cerebral disease, often has underlying uncontrolled diabetes, immunosuppressive therapy in moderate to severe cases Design/Methods: We systematically reviewed 65 patients diagnosed with post covid ROCM with cerebral abscess admitted to the hospital during MAY 2021 to AUGUST 2021.Data pertaining to demographic variables, clinico-radiological features were analysed using percentage of total cases Results: Of 65 patients, incidence is more in the age group of 40-60yrs, males are more affected than females. Risk factors - inadvertent steroid use [ 89%], diabetes mellitus [ 81%], CKD [0.07%], HIV[ 0.03%].clinical profile include headache [97%], seizure [80%], vomitings [60%], focal neurologic deficit [18%], encephalopathy [3%]. Radiological profile showed abscess in temporal lobe [49%], frontal lobe [28%], occipital [14%], parietal [6%], optic nerve[ 3%]. Conclusions: Caution needs to be exercised with regard to Glycemic control, widespread usage of corticosteroids to reduce super infections. Expedient commencement of antifungal therapy together with surgical debridement help to improve the survival of these patients. In a country with prevalence of high risk factors and relatively poor resources, covid vaccination programmes should be the topmost priority to avoid massive outbreaks, complications and mortality.
ABSTRACT
Objective: To provide an overview of the pattern of neuroaxis involvement and clinicoradiological correlation in post covid rhino orbital cerebral mucormycosis cases. Background: The COVID-19 has spread worldwide since December 2019. In India, the peak of COVID-19 Infections in APRIL 2021 was paralleled by an outbreak of rhino-orbital-cerebral mucormycosis (ROCM), a fulminant angioinvasive fungal infection involving various neural axis. Design/Methods: We systematically reviewed 100 patients diagnosed with post covid ROCM admitted to the hospital during APRIL 2021 to JUNE 2021. Data pertaining to clinicoradiological features were analysed using percentage of total cases. Results: Of 100 patients of post covid ROCM, clinical manifestations include headache[90%], facial pain [88%], ophthalmoplegia [87%], loss of vision [85%], proptosis [85%], dizziness [60%], cerebrovascular accidents [24%], seizures[20%], encephalitis[3%]. Radiological profile suggestive of Cranial nerve involvement [45%], Early cerebritis [40%], Cerebral abscess [25%], Cavernous sinus thrombosis[20%], ICA stenosis[16%], Cerebral infarct[9%], Leptomeningeal enhancement[6%]. Conclusions: Neuroaxis involvement was characterized by a multitude of features pertaining to involvement of cranial nerves, extraocular muscles, meninges, cavernous sinus brain parenchyma and internal carotid artery. High index of suspicion is required to ensure timely diagnosis and appropriate treatment in high-risk populations to prevent High mortality.