scholarly journals The double trouble: COVID-19 associated mucormycosis a focused review and future perspectives

2021 ◽  
Vol 16 ◽  
pp. 4
Author(s):  
Arun Kumar Agnihotri ◽  
Monika Vij ◽  
Okezie I. Aruoma ◽  
Vipul D Yagnik ◽  
Theeshan Bahorun ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Fungal Infections ◽  
Fungal Spores ◽  
Diabetic Patients ◽  
Corticosteroid Administration ◽  
Uncontrolled Diabetes ◽  
The Family ◽  
Need To Evaluate ◽  
The Many

Mucormycosis, a deadly fungal infection, has affected thousands of COVID-19 patients in India. Mucormycosis, formerly known as zygomycosis, is caused by the many fungi that belong to the family “Mucorales.” These molds are commonly found in soil, air, and damp walls and frequently colonize oral mucosa, nose, paranasal sinuses, and throat. The pathophysiological consequences of diabetes combined with the acute inflammatory surge in COVID-19 and steroid treatment weakens person’s immunity and renders susceptibility to fungal infections. Patients treated for severe COVID-19 have damaged lungs and suppressed immune system, an environment that supports fungal infection. Fungal spores can grow in airways or sinuses, and invade bodies’ tissues, explaining why the nasal cavity and paranasal sinuses are the most common site of mucormycosis infection, the consequential spread to the eyes can cause blindness, or causing headaches or seizures if the infection spreads to the brain. Poorly controlled diabetes often results in acidosis in tissues a suitable environment for Mucorales fungi to grow, exacerbating the risk for mucormycosis. This becomes clinically important, especially in India that has an increased prevalence of undiagnosed and uncontrolled diabetes. Given that a significant increase in the cases of mucormycosis in the diabetic patients treated for COVID-19 is strongly associated with corticosteroid administration, there is a need to evaluate use of dietary nutraceuticals with immune boosting potentials that modulate metabolic abnormalities in the management of COVID-19 associated mucormycosis.

scholarly journals Autopsy dissection techniques and investigations in deaths due to COVID-19 triggered fungal infections - A diagnostic review

2021 ◽  
Vol 8 (4) ◽  
pp. 207-213
Author(s):  
Himanshi Narang ◽  
Amit Patil
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Fungal Infections ◽  
Invasive Disease ◽  
Invasive Fungal Infections ◽  
Correct Interpretation ◽  
Research Papers ◽  
Dissection Techniques ◽  
Second Wave

The COVID-19 pandemic, which originated from Wuhan, China, has rapidly spread worldwide, including India. As India grappled with the second wave, COVID-triggered fungal infection has suddenly risen tremendously, raising a sense of panic in the country. The fungal infection in COVID-19 includes Mucormycosis and Aspergillosis, as common fungal infections primarily affecting rhino-orbital structures. Many research papers have published postmortem findings in autopsies conducted on COVID-19 decedents, thereby helping to understand this contagious disease's pathogenesis. But, with the arrival of COVID-triggered fungal infection, which is a crucial invasive disease responsible for fatality, very few research papers have commented on the postmortem findings of invasive fungal infections affecting the rhino-orbital and craniocerebral structures in COVID-19 deaths. Therefore, the role of invasive fungal infection due to COVID-19 illness must be established in the causation of deaths in COVID-19 patients. This review research deals with autopsy dissection techniques and possible postmortem findings of invasive fungal infections involving the nasal and paranasal sinuses and orbital structures in COVID-19 deaths. The findings of fungal infection affecting nasal and paranasal systems may not differ in live patients and in a deceased; however, it is essential that correct interpretation of the postmortem findings aided by pre-or post-autopsy investigations is necessary to establish the role of covid triggered fungal infection in such deaths.

scholarly journals Mucormycosis involving paranasal sinuses in a post-COVID-19 patient with an uncontrolled diabetes-A rare presentation in an ongoing pandemic

2021 ◽  
Vol 6 (2) ◽  
pp. 137-140
Author(s):  
Sankalp Yadav ◽  
Novelesh Bachchan ◽  
Gautam Rawal ◽  
Pallawi Rai
Keyword(s):  
Mortality Rate ◽  
Fungal Infection ◽  
Opportunistic Infection ◽  
Paranasal Sinuses ◽  
Ethmoid Sinus ◽  
Rare Presentation ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
Second Wave ◽  
Indian Male

Mucormycosis (MCR) involving paranasal sinuses is a rare life-threatening opportunistic infection in immunocompromised individuals. In humans, MCR is considered as one of the most rapidly progressive lethal forms of fungal infection with a high mortality rate of 70–100%. During the second wave of COVID-19 in India, the cases of MCR have increased rapidly. We herein report a case of a 70-year-old Indian male with an uncontrolled diabetes diagnosed as maxillary and ethmoid sinus MCR.

scholarly journals Case analysis and systematic review of aspergilloma

2021 ◽  
Vol 7 (9) ◽  
pp. 1490
Author(s):  
Georgia Benitha J. ◽  
Prathiba Ramani ◽  
Reshma Poothakulath Krishnan ◽  
Gheena S. ◽  
Abhilasha R.
Keyword(s):  
Systematic Review ◽  
Fungal Infection ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Full Text ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Dental Procedures ◽  
Full Text Review ◽  
Predisposing Conditions

<p class="abstract">Among various fungal pathogens, <em>Aspergillus fumigatus</em> is the most prevalent human pathogen reported to cause human disease such as aspergilloma or aspergillosis. Aspergillomas are commonly seen in a poorly drained and avascular cavitary space which evokes an inflammatory reaction. Most commonly involving paranasal sinuses especially maxillary sinus. For the past 2 decades incidence of aspergillosis has increased substantially. The main objective of this systematic review was to evaluate the cases reported to be aspergilloma of maxillary sinus and to determine the percentage of cases involving aspergilloma of maxillary sinus in healthy individuals. After the final full text review, 16 articles were included in this systematic review. Data were extracted from the full text articles and reviewed and extracted content. About 83% had a history of dental procedures, with 42% of those being due to infection from previous extraction sockets and 41% due to RCT. About 43% of the patients in this study were immunocompromised, while 56% were healthy and had no known predisposing conditions. The aspergillus fungal infections affecting the paranasal sinuses are common which can affect apparently healthy as well as immunocompromised individuals. Aspergilloma is the most common fungal infection involving maxillary sinus with iatrogenic dentogenic factors being the most predominant factor for the initiation and progression of aspergillus fungal infection. About 43% of the patients in this review were immunocompromised patients whereas 56% of the patients were healthy without any known predisposing conditions. The progression and prognosis of these diseases depends on the location and immunologic status of the patient. So, it is very important for the dentists to be more cautious while performing any dental procedures so as not to initiate any iatrogenic infections.</p>

scholarly journals Correlation of diabetes with mycotic infections: a pilot study

2021 ◽  
Vol 8 (4) ◽  
pp. 1671
Author(s):  
Manish Munjal ◽  
Naveen Mittal ◽  
Ekta Bansal ◽  
Shubham Munjal ◽  
Devambika Mehta ◽  
...  
Keyword(s):  
Pilot Study ◽  
Prospective Study ◽  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Fungal Infections ◽  
Fungal Species ◽  
Age Group ◽  
Medical College ◽  
High Incidence ◽  
Mycotic Infections

Background: The immuno-compromised individuals have a high Incidence of fungal infections of the nose and the paranasal sinuses. There is a variation in the fungal species that manifest in different subset of individuals. The species and the susceptible individuals were studied in the Punjab population, to suggest measures to attain a better outcome.Methods: 50 subjects treated for paranasal fungal infection by rhinology division of the oto-rhino-laryngology services, Dayanand Medical College and hospital, Ludhiana, were analysed. The prospective study was carried out in a period of one and a half year (June 2009 to December 2010).Results: Mycotic infections was predominantly noted in the age group  51-60 years  i.e. in 14 patients (28%) followed by 41-50 years, 13 cases (26%). There were 29 (58%) of males and 21 (42%) females with a male:female ratio of 1.4:1. Amongst 50 patients with mycotic infection, 19 (38%) were diabetic. All 15 (100%) patients with zygomycosis had underlying diabetes while only 4 (21%) with aspergillosis were diabetic.Conclusions: Zygomycosis occurs usually in diabetics, while in aspergillosis the underlying morbidity may or may not be diabetes. Timely medical treatment is essential to check diabetes and species identification to select the appropriate antifungal medication. 

scholarly journals Study on management of fungal infections of nose and parnasal sinuses

2018 ◽  
Vol 5 (1) ◽  
pp. 45
Author(s):  
Prasad A. Kelkar ◽  
Jyoti V. Hirekerur
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Antifungal Agents ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Detailed Examination ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Adequate Dose ◽  
Nose And Paranasal Sinuses

<p class="abstract"><strong>Background:</strong> From last few years, the fungal infection has been increasing due to greatly enhanced international traffic and as opportunistic infections in consequence of use of powerful cytotoxic drugs. The disease invariably occurs in diabetics, usually with ketoacidosis, immune compromised patients. Hence, we planned to undertake the present study to evaluate a standard method of management of fungal infections of nose and paranasal sinuses.</p><p class="abstract"><strong>Methods:</strong> A detailed examination of the nose and pranasal sinuses was carried out in the department of ENT. The patients were continuously monitored with pulse oximetry and ECG monitor. In all patients, nasal endoscopy was performed.  </p><p class="abstract"><strong>Results:</strong> In this study, fungal infections of the nose and paranasal sinuses were found to be common between 20 and 50 years of age. Aspergillosis was the commonest sinonasal fungal infection followed by allergic fungal sinusitis, rhinosporidiosis and mucormycosis.</p><p class="abstract"><strong>Conclusions:</strong> Early detection, proper and adequate dose of antifungal agents, timely surgical intervention in the form of debridement and sphenoethmoidectomy and orbital exenteration improve the survival rate in the disease of sinonasal fungal infections.</p><p> </p>

scholarly journals COVID-19 Associated Rhino-Orbital-Cerebral Mucormycosis - An Institutional Series

2022 ◽  
Vol 4 (1) ◽  
pp. 01-09
Author(s):  
Nishant Rana
Keyword(s):  
Risk Factor ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Host Defenses ◽  
Uncontrolled Diabetes ◽  
The World

Invasive fungal infection or mucormycosis is almost always confined to the patients with altered host defenses such as in transplant recipients, diabetics or patients with malignancies. Hypergycemia or uncontrolled diabetes, particularly diabetes acidosis is considered as the strongest and very well known risk factor for mucormycosis. It has spread like fire amongst the active COVID-19 and post COVID-19 diabetic patients. Many studies across the world have established the definitive severity of SARS-CoV-2 infection amongst diabetic patients.

scholarly journals Fulminant Mucormycosis Involving Paranasal Sinuses: A Rare Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Komali Garlapati ◽  
Sunanda Chavva ◽  
Rahul Marshal Vaddeswarupu ◽  
Jyotsna Surampudi
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Rare Case ◽  
Maxillary Antrum ◽  
Fungal Spores ◽  
Direct Invasion ◽  
Susceptible Patient ◽  
Rare Case Report ◽  
Nose And Paranasal Sinuses ◽  
Diabetic Individual

Mucormycosis is an opportunistic fulminant fungal infection, which has the ability to cause significant morbidity and frequently mortality in the susceptible patient. Common predisposing factors include diabetes mellitus and immunosuppression. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes necrosis of the tissue. The infection can spread to orbital and intracranial structures either by direct invasion or through the blood vessels. Here we describe a case of mucormycosis of maxillary antrum extending to ethmoidal and frontal sinus and also causing necrosis of left maxilla in an uncontrolled diabetic individual to emphasize early diagnosis and treatment of this fatal fungal infection.

scholarly journals Relationship Between Acanthosis Nigricans and Fungal Infection: Clinical and Histopathological findings

2021 ◽  
pp. 1-7
Author(s):  
Joon Woo Jung ◽  
Eun Hye Hong ◽  
Eun Joo Park ◽  
Kwang Joong Kim ◽  
Kwang Ho Kim
Keyword(s):  
Fungal Infection ◽  
Medical Records ◽  
Acanthosis Nigricans ◽  
Fungal Infections ◽  
Fungal Spores ◽  
Skin Condition ◽  
Skin Changes ◽  
Clinical Difference ◽  
Cutaneous Fungal Infection ◽  
The Relationship

Background: Acanthosis nigricans (AN) is a skin condition that presents clinically with hyperpigmented, hyperkeratotic, and velvety skin changes, especially in the intertriginous areas. The intertriginous areas are also susceptible to superficial cutaneous fungal infections. The potential relationship between AN and cutaneous fungal infection has not been investigated. Objective: The aim of this study was to determine the relationship, if any, between AN and fungal infection, both clinically and pathologically. Methods: A retrospective review was performed using electronic medical records and histology of biopsy slides obtained from 29 patients who were diagnosed with AN by two dermatopathologists. Comparison was made between the clinical and pathological findings of AN with fungal infection (ANFI+) and AN without fungal infection (ANFI-). Results: Among the 29 patients with AN, fungal spores were detected on the biopsy slides of 18 patients (62.1%) and appeared in the epidermal furrow more often than in the epidermal ridge. No significant clinical difference was found between the ANFI+ and ANFI- groups; however, in the ANFI+ group, lesions were more prevalent in the neck area (p = 0.048). In addition, the ANFI+ biopsy slides revealed more papillomatosis than ANFI- biopsy slides (p = 0.006). Conclusion: Fungal infection tends to appear in combination with AN when more severe papillomatosis is also present.

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

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