Rhino-cerebral Mucormycosis In Post- Covid 19 Patient: A case report
Author(s): Juee Meghe*, Shilpa Bawankule, Zahiruddin Syed Quazi, Abhyuday Meghe and Pallavi Yelne
Abstract
Introduction: There was a sudden surge in mucormycosis cases which were observed during April and May of 2021 due to excessive and irrational use of steroids among COVID-19 patients. Here we are reporting a typical case of COVID-19 related rhino cerebral mucormycosis and its management.
Presentation of case: The patient reported in this case was diagnosed with COVID-19 and undergone treatment according to the government protocols for COVID. Following recovery after 10 days the patient complained of pain over the upper jaw i.e. bilateral sinus region, toothache and persistent headache for 4-5 days. MRI and CT scan showed bilateral sinusitis. On direct nasal endoscopy, mucormycosis was confirmed. Early management with Intravenous (IV) liposomal amphotericin B, clindamycin and tab. Posaconazol was done with surgical debridement.
Discussion: Mucormycosis is a rare but fatal infection, which is reported to develop as an opportunistic or secondary infection due to immunosuppression or other chronic diseases. The fungus enters through the respiratory tract and progressively invades nose and sinuses with potential of invading the orbital and intracranial tissues. Due to increasing COVID-19 cases susceptibility towards this infection is raising in post COVID patients. For good prognosis early diagnosis and timely intervention is required, which can be initiated at the earliest depending on the clinical findings.
Conclusion: Prophylactic treatment needs to be provided for better prevention, management and control of opportunistic infections. Rational use of steroids should be done; along with it glycaemic control needs to be taken care of by giving necessary amounts of insulin.