ABSTRACT
Mucormycosis, which is a life threatening condition, is one of the side effects experienced by post-COVID-19 patients. Early identification and timely treatment are essential to stop the dissemination of the disease, since invasive mucormycosis has a very high fatality rate and significant disease dispersion. Conventional diagnostic techniques, including clinical diagnosis, serology, histopathology and radiology, have limitations in diagnosing the disease at an early stage. This warrants the need for advanced diagnostic tools such as nucleic acid diagnostics, advanced serological tests (ELISpot), PCR (pan-Mucorale test) and multiplex PCR. These techniques have been introduced to identify this invasive fungal infection at an incipient stage, thereby helping clinicians to prevent adverse outcomes. The use of biosensors and micro-needle based diagnostic methodologies will pave the way for devising more point-of-care tests that can be employed for the detection of mucormycosis at an incipient stage. The present review discusses the current techniques available and their drawbacks, and the usefulness of advanced diagnostic tools. Furthermore, the possibility of using future diagnostic methods for the diagnosis of mucormycosis is highlighted.
ABSTRACT
The restoration of speech, deglutition, mastication, and respiration in patients with bimaxillary resection involving the maxillae, hard and soft palates, and paranasal sinuses poses a significant challenge. This clinical report describes the prosthodontic management of a patient with bilateral maxillectomy caused due to post-COVID-19 mucormycosis. A patient-specific implants (PSI) that matched the remnants of the zygoma complex was designed to improve the patient's severely impaired speech and swallowing. The patient's postsurgical anatomy was first visualized using three-dimensional computed tomography data. Following that, a customized zygoma-supported titanium framework was designed to support the prosthesis based on the data. Two weeks after the framework was installed, an open-tray impression was made and the prosthesis was fabricated. These findings suggest that PSI-retained prosthesis can be considered in cases with severely compromised maxillary bone anatomy, impaired oral functioning, and no viable conventional reconstruction options.
ABSTRACT
BACKGROUND: Reports of mucormycosis, an infectious disease that commonly affects immunocompromised individuals, have increased during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Disseminated mucormycosis associated with COVID-19 is rare but fatal and is characterized by an aggressive clinical course and delayed diagnosis. Our report documents a case of disseminated mucormycosis after COVID-19 infection. This is a rare pathological autopsy report on COVID-19-associated mucormycosis. CASE SUMMARY: A 58-year-old man was transferred to our hospital with severe COVID-19 pneumonia. During treatment for acute respiratory distress syndrome, he developed intra-abdominal bleeding that required a right hemicolectomy and ileostomy for hemostasis. The ileostoma and surgical wound developed necrosis followed by sepsis and multi-organ failure, which led to death. An autopsy revealed multiple thrombi associated with Rhizopus oryzae infection, which led to the necrosis of multiple infected organs. CONCLUSION: Early suspicion and diagnosis followed by treatment are keys to better outcomes of mucormycosis in patients with severe COVID-19.
ABSTRACT
Introduction: The incidence of mucormycosis in post COVID-19 cases increased in the second wave. Patients who had COVID-19 infection with pre-existing co-morbidities underwent treatment and resultant immunosuppression made them vulnerable to secondary infections like mucormycosis. Aim: To analyse the knowledge, level of awareness and practice among the dental professionals towards the mucormycosis infection in patients of post COVID-19 disease. Materials and Methods: The cross-sectional survey was conducted from May 2021 to June 2021 among 428 dental professionals residing in Tamil Nadu, India. The 16 item questionnaire consisted of questions about knowledge, awareness and practice regarding post COVID-19 mucormycosis infection by dental professionals and were sent to the dental practitioners through online portals. The responses were tabulated and the results were analysed using Chi-square test. Results: The study participants included 264 (61.68%) females and 164 (38.32%) males dental professionals. The dental professionals who participated were in the age range of 21 years to 45 years with a mean of 29.87 +/- 6.52 years. The subjects were categorised under general dental practitioners 254 (59.34%), postgraduate students 96 (22.4%), specialty dental practitioners 78 (18.22%). Total 406 (94.86%) respondents agreed that oral examination is necessary for post COVID-19 patient. Out of 428, 306 (71.49%) of the participants responded that tooth pain associated with headache is a watchful sign in diabetic post COVID-19 patients. Conclusion: This study emphasises the role of dental professionals in diagnosis and management of mucormycosis infection in patients of post COVID-19 disease. Dental professionals demonstrated adequate knowledge about post COVID-19 mucormycosis. This may act as a source of information for the future pandemic crisis.
ABSTRACT
OBJECTIVE: To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease. METHODS: A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection. RESULTS: Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment. CONCLUSION: New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.