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Post-Covid Cerebral Mucormycosis, Varied Presentations and Surgical Strategies of a Newer Epidemic: An Institutional Experience.
Vijayasekhar, Manda Venkata; Nagappa, Vivek; Swaroop, Kurumella Hema; Mithun, Gorre; Achuith, Ediga; Varaprasad, Kadali Satya.
  • Vijayasekhar MV; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
  • Nagappa V; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
  • Swaroop KH; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
  • Mithun G; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
  • Achuith E; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
  • Varaprasad KS; Department of Neurosurgery, Andhra Medical College, Andhra Pradesh, India.
Neurol India ; 70(3): 1052-1056, 2022.
Article in English | MEDLINE | ID: covidwho-1934349
ABSTRACT
Context During the challenging second wave of the COVID-19 pandemic, we encountered a most dreadful fungal infection in the form of COVID-associated mucormycosis (CAM), with a varied pattern of presentation from previous experience. Patients presented with simple fungal sinusitis or more complicated brain abscesses, and newer manifestations such as skull osteomyelitis. We report our findings and innovative treatment strategies used to manage this morbid condition.

Objectives:

To study the various presentations and surgical strategies in treating post-COVID rhino-orbito-cerebral mucormycosis (ROCM). Settings and

Design:

Observational cross-sectional study. Methods and Materials From May to October 2021, 270 patients with CAM were admitted to Andhra Medical College Department of Neurosurgery, King George Hospital, Visakhapatnam, India. A cohort of 61 cases with intracranial involvement was studied in detail. The varied presentations and different or innovative treatment modalities were analyzed.

Results:

The death rate was 30/270 in the whole cohort, and three deaths (4.9%) occurred in 61 cases with cranial involvement. Thirty-three (54.1%) of the 61 cases were treated surgically 17 patients required bone excision (for focal osteomyelitis) and 16 cases required abscess drainage/excision.

Conclusions:

Post-COVID mucormycosis (especially with intracranial involvement) is a highly challenging entity. A multidisciplinary approach with early and aggressive anti-fungal medication combined with timely surgical interventions offers some hope of overcoming this complex infection in CAM patients. We identified some novel techniques during regular follow-up that have proven helpful in combatting this devastating condition.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteomyelitis / COVID-19 / Mucormycosis Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Neurol India Year: 2022 Document Type: Article Affiliation country: 0028-3886.349604

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteomyelitis / COVID-19 / Mucormycosis Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Neurol India Year: 2022 Document Type: Article Affiliation country: 0028-3886.349604