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Covid-19-associated fungal osteomyelitis of jaws and sinuses: An experience-driven management protocol.
Suresh, Amal; Joshi, Abhijit; Desai, Anil Kumar; Juturu, Uday; Kurian, Denis Jacob; Jain, Pavithra; Kulkarni, R D; Kumar, Niranjan.
  • Suresh A; Assistant Professor, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Surgery and Research Centre, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Joshi A; Additional Professor, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Surgery and Research Centre, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Desai AK; Professor and Head, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Surgery and Research Centre, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Juturu U; Resident, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Surgery and Research Centre, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Kurian DJ; Resident, Department of Oral and Maxillofacial Surgery, SDM Craniofacial Surgery and Research Centre, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Jain P; Assistant Professor, Department of Microbiology, SDM College of Medical Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Kulkarni RD; Professor and Head, Department of Microbiology, SDM College of Medical Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
  • Kumar N; Professor and Head, Department of Plastic and Reconstructive Surgery, SDM College of Medical Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, 580009, Karnataka, India.
Med Mycol ; 60(2)2022 Feb 02.
Article in English | MEDLINE | ID: covidwho-1648766
ABSTRACT
Invasive fungal co-infections with COVID-19 are currently being reported at an alarming rate. Our study explores the importance of early identification of the disease, probable etiopathogenesis, clinical and radiological features and a treatment protocol for COVID-19 Associated Fungal Osteomyelitis of Jaws and Sinuses (CAFOJS). A one-year prospective study from June 2020 to May 2021 was conducted among CAFOJS diagnosed patients at a tertiary care center in South India. Demographic details, COVID-19 infection and treatment history, time taken for initiation of symptoms after COVID-19 diagnosis, medical history and clinical features were recorded. All patients were managed with a standard diagnostic and intervention protocol which included pre-operative and post-operative administration of Inj. Amphotericin B 50 mg (liposomal), early aggressive surgical debridement and tab. Posaconazole GR 300 mg OD for 90 days after discharge. Thirty-nine (78%) patients were diagnosed with CAFOJS out of 50 osteomyelitis patients. 35 patients (90%) were diabetic and 21 patients (54%) were known to receive steroids during the COVID-19 treatment. Sole existence of Mucorales spp. was seen in 30 patients (77%), Aspergillus fumigatus in 2 patients (5%), Curvularia spp. in 2 patients (5%). Concomitant existence of Mucorales and Aspergillus fumigatus was reported in two patients (5%) and Candida albicans in three patients (8%). Patients underwent treatment with standard protocol and no recurrence noted. CAFOJS is a clinical entity with aggressive presentation and warrants early diagnosis and treatment. LAY

SUMMARY:

Invasive fungal infections of head and neck region cause necrosis of bones affected by it, especially maxilla. Early diagnosis and treatment are advocated in such infections due to its aggressive clinical presentation compared to similar infections before COVID-19 pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteomyelitis / COVID-19 / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal subject: Veterinary Medicine / Microbiology Year: 2022 Document Type: Article Affiliation country: Mmy

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteomyelitis / COVID-19 / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal subject: Veterinary Medicine / Microbiology Year: 2022 Document Type: Article Affiliation country: Mmy