DR. VIDYA BHUSHAN KUMAR

DR.MOBASHIR SARFRAZ ALI, DR SHIVANI SINHA, DR. VIVEK SINGH

Abstract

After second wave of COVID-19 there was a sudden abrupt increase in number of life threatening mucormycosis cases, involving Para nasal sinus, orbit and brain ( rhino-orbital-cerebral Mucormycosis- ROCM). We had to deal with more 150 cases of ROCM at various stages. We worked as a team with ENT, Dental and Neuro surgeon at tertiary center in Bihar.

we analyzed patient data, the major risk factors included recent use of steroids, uncontrolled diabetes, and immunocompromised stage. The most common presentation was swelling of unilateral eye and ptosis and proptosis, followed by loss of vision. Inflammatory marker (CRP) and d-dimer were raised at presentation in all cases. Intravenous Amphotericin-B was given to all patients for at least 4 weeks. Majority of cases were operated for debridement of paranasal sinus, about 25% patient underwent orbital exenteration and hemi maxillectomy surgery. Despite antifungal therapy and aggressive surgical intervention mortality rate was very high.

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