SPECTRUM OF MUCORMYCOSIS CASES ASSOCIATED WITH COVID 19, PRESENTING WITH NEW MANAGEMENT PROTOCOL FROM ORAL & MAXILLOFACIAL SURGICAL UNIT OF A PUBLIC SECTOR TERTIARY CARE HOSPITAL PAKISTAN

S KUMAR; S KATPAR; M DIN; TU NISA; T KHAN; M HUSSAIN

doi:10.54112/pjicm.v4i02.39

Authors

S KUMAR Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan
S KATPAR Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan
M DIN Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan
TU NISA Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan
T KHAN Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan
M HUSSAIN Department of Oral & Maxillofacial Surgery, DUHS and SMBB Institute of trauma, Karachi, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v4i02.39

Keywords:

Rhino Orbital Cerebral Mucormycosis (ROCM), Covid-19, Bismuth Iodoform Paraffin Paste (BIPP), Covid Associated Mucormycosis (CAM), Oral & Maxillofacial Surgery (OMFS)

Abstract

Background: This original and pioneer national clinical study highlights the surge of COVID-19-associated mucormycosis, a life-threatening fungal infection with high morbidity and mortality, particularly in diabetics and immunocompromised patients. It underscores the critical role of early diagnosis and aggressive surgical intervention in improving patient outcomes. Objective: To present the clinical features of Rhino-orbital cerebral mucormycosis (ROCM) cases managed and its association with the COVID-19 Pandemic. Study Design: Descriptive cross-sectional. Duration of Study: December 2022 to December 2023. Study Settings: The study was conducted at the Department of Oral & Maxillofacial Surgery (OMFS), located at SMBBIT and affiliated with DUHS, over one year after Institutional Ethical approval. Methods: Patients managed included, both genders with strong clinical suspicion of fungal ROCM infection, whereas Patients with other odontogenic maxillofacial bacterial infections were excluded. Data were collected on demographics, COVID-19, comorbidities, and surgical treatment details with BIPP Dressings. Data was collected and analysed using SPSS version 25 to identify trends and associations. Results: Amongst 28 Rhino orbital cerebral mucormycosis (ROCM) cases, nine patients had a positive history of COVID-19. The highest prevalence occurred in the 51–60 age group, male gender was predominant forming 75%. Diabetes mellitus was the leading comorbidity (53.57%). The midface & paranasal anatomical region was the most commonly affected anatomical site (46.42%). The most frequent surgical intervention was partial maxillectomy and BIPP dressings were used for all cases. Conclusion: Rhino-orbital cerebral mucormycosis (ROCM) primarily affects COVID-19 patients with underlying comorbidities. Early diagnosis with aggressive surgical intervention is critical, and Bismuth Iodoform Paraffin Paste (BIPP) is essential in controlling local infection and reducing mortality.

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