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Volume 27, Issue 133, March 2023

Post COVID-19 recurrent rhino ocular cerebral mucormycosis: A curse like no other

Chrisann Saldanha¹, Sachin Daigavane², Vadlamudi Nagendra³

¹Junior Resident, Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India
²Professor and HOD, Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India
³Junior Resident, Department of Radio-diagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India

ABSTRACT

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has been linked to a number of opportunistic bacterial and fungal infections. Aspergillus and Candida have been identified as the primary fungal pathogens for COVID-19 co-infection. Recently, several cases of mucormycosis in COVID-19 patients have been reported worldwide, particularly in India. Now, remember that mucormycosis can be of different types like rhino-ocular-cerebral (ROCM), pulmonary, gastrointestinal, etc., here we are dealing with a case of rhino-ocular cerebral mucormycosis which not only occurred once but twice post covid-19 infection. As we recover from the epidemic and the pandemic, it is essential to look back and understand what led to the insane surge of mucormycosis in post-covid-19 patients, especially in our country, India. Mucor is ubiquitous and present constantly around us, so no single factor but an array of elements is responsible predominantly being the incorrect use of corticosteroids in uncontrolled diabetics, which led to severe immunosuppression, injury to the beta cells of the pancreas by the SARS-COV-2 in newly diagnosed diabetics. In such cases, it is important to evaluate the patient thoroughly and orbital exenteration is done depending upon the doctor’s judgment and MRI findings. Following is a case report of one such patient with recurrent post COVID mucormycosis predisposed by uncontrolled diabetes mellitus and managed by orbital exenteration.

Keywords: Mucormycosis, recurrence, exenteration, amphotericin B, MRI, Orbital extension