RHINO-ORBITO-CEREBRAL MUCORMYCOSIS
(BLACK FUNGUS) IN COVID 19 PATIENTS
ABSTRACT BACKGROUND Mucormycosis (Black fungus) is a designated as a rare, rapidly progressive fatal disease of immunocompromised caused by saprophytic fungus of family mucorales. Early diagnosis with prompt medical and surgical treatment is the only tool available. Rhino-orbito-cerebral is the most common subtype. In India we saw a sudden rise in mucormycosis cases during second wave of COVID 19. This necessitated a systematic review of epidemic of mucormycosis in COVID 19. METHODS A Retrospective multi-centric study was conducted at various Government and Private Hospitals of Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent COVID19 positive status presenting to us during 14th April 2021- 31st May 2021. RESULT Either Type2 Diabetes Mellitus or history of recent use of steroids in high doses was present in all the patients. Contribution of virulence of the Delta strain B1.617.2 is significant. FESS with sino-nasal debridement contributes significantly towards mortality reduction and cost of total treatment by significantly reducing days of Liposomal Amphotericin B therapy. CONCLUSION Early diagnosis with prompt medical and surgical management along with blood sugar control and avoiding use of high dose of steroids remain to key to mortality and morbidity reduction. Keywords: Black fungus, mucor, mucormycosis, rhino-orbito-cerebral, causes, treatment, covid 19, India, sugar, steroids, steam, oxygen, surgery