Mucormycosis Post COVID Recovery
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Background: Currently, COVID (Coronavirus disease) case and death incidences both are at their unprecedented levels since beginning of pandemic worldwide. The viral onslaught and it’s management involving use of steroids and immunomodulatory drugs, disrupt normal immune functioning. This immune suppression could trigger the development of opportunistic infections such as mucormycosis. We wish to explore the transmission, warning signs, risk factors, diagnosis and management of mucormycosis post COVID recovery.
Mucormycosis and it surge post COVID: It is a rare, fatal, opportunistic fungi which is ubiquitous and usually found in soil and decaying vegetation. It spreads either through inhalation of spores or ingestion of the microorganism. It causes five types of infections; rhinocerebral (most common), pulmonary, cutaneous, gastrointestinal and disseminated. COVID has tendency to worsen diabetes, it causes immune dysregulation and requires steroids and immunomodulators for it’s management, all these predispose the patients to mucormycosis.
Risk factors and warning signs: Patients who are diabetic, transplant recipients, prolonged ICU stay, cancer patients, and those requiring steroids, immunomodulators or voriconazole therapy. Facial swelling, fever, headaches, nasal or sinus congestion, discharge from nose, toothache, gum abscess, loosening of teeth, blurred or double vision and skin lesions.
Diagnosis and management: Early diagnosis can be done through biopsy, KOH mount and Calcofluor stain. Culture, serology, molecular methods and sequencing are other methods for further identification. Surgical debridement, antifungal therapy and control of underlying risk factor are key to a good prognosis
Conclusion: A multidisciplinary team working in conjunction is the best approach for management of mucormycosis. Good glycemic control, restricted use of steroids, universal masking and awareness about when to suspect and seek medical attention can go along way in preventing this deadly fungal infection.
Keywords: Mucormycosis, Post COVID, Steroids, Diabetes mellitus, Prolonged ICU stay
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