28 yrs, old, Male patient With positive h/o of Covid-19 virus , gradual devloped Redness & Itching than Blackening of rt eye After 5 days of hospital admission likely to be Mucormycosis..Kindly suggest Investigation & Mx of this patient History No family h/o Chief Complaints Headache, Conjuctivitis , Blurring of vision

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A classical presentation of mucormycosis in a Covid -,19 patient . I just suggest my colleagues to please use Steroids very judiciously in covid - 19 patients .It is indiscriminate use of steroids in COVID-19 patients which have increased the incidence of mucormycosis Warning signs include pain and redness around the eyes or nose, with fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status. According to the advisory, infection with mucormycetes should be suspected when there is: * Sinusitis — nasal blockade or congestion, nasal discharge (blackish/bloody); * Local pain on the cheek bone, one-sided facial pain, numbness or swelling; * Blackish discoloration over bridge of nose/palate; * Loosening of teeth, jaw involvement; * Blurred or double vision with pain; * Thrombosis, necrosis, skin lesion; * Chest pain, pleural effusion, worsening of respiratory symptoms.

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Classical example of MUCORMYCOSIS seen in adults at typical site of infection All signs and symptoms mentioned are suggestive of MUCORMYCOSIS For investigations nothing much is required but koh staining for microscopic analysis or culture to confirm Rx debridement of all blackened debri Inj amphotercinB Sos flucanazole Rest supportive treatment To keep in mind about nasocerebral MUCORMYCOSIS Monitor keenly

Thanx dr Ashok Leel
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Mucormycosis or Black fungus is most likely in this situation when immunity is compromised due to over use of corticosteroids.It may rapidly spread to meninges ,sinuses and rapidly spread to whole body .Reduce steroid and give Antifungal IV Amphotericin or iv/oral posaconazole /isavuconazole in suitable doses and debriedement of involved tissues if possible.Inspite of best treatment mortality is more then 50%.

Thanks for all persons who appreciated the answer.
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It's a confirmed case of Mucormycosis. Covid 19 + Over use of Steroid + Humidity (Moist) of O2 ...these are the prime causes. Pt must be consulted by ENT & Neuroscience surgeon + Opthalmologist..

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Rhino cerebral mucormycosis Start Empirical Amphotericin B liposomal + Posaconazole Advice - MRI BRAIN with contrast and Surgical biopsy for fungus Did mucormycosis always develop in hospitalised covid patient or it can develop in home isolation ?

Three factors play an important role in causing mucormycosis. Diabetic status of patient, immunocompromise (which can be due to Covid, organ transplant or immunosuppressive drugs like steroids) and oxygen therapy (mostly due to use of non distilled water in vaporizer / flow meter)
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Mucormycosis Inj Lyposomal Amphotericin B 10mg/kg distilled in 5D iv slowly May produce hypokalaemia, see Potassium level after infusion Further refer to eye surgeon for needful Symptomatic supports

? MUCORMYCOSOSIS .. WITH .. RT..SIDE .. EYE INVOLVEMENT .. NEED'S.. EYE EXAMINATION WITH EXPERTS OPINION...

Tnx Dr Datta G Narayankar
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Mycormycosis.. with Rt eye and face involvement.. Nothing special investigation. H/O diabetes with post covid and post covid Infection. Debridement of blackened skin Inj Amphotericin B Fluconazole SOS Supportive treatment. Regular monitoring and constant evaluation required to avoid any eventuality.

Thanks Dr Rakesh kashth
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POSSIBLY... RHINO CEREBRAL MUCORMYCOSIS DD ACTINOMYCOSIS... ADVISABLE ..... C T. SCAN .... BIOPSY. AND. CULTURE. AND. SENSITIVITY TESTS EMPIRICAL. ..MANAGEMENT ....... TILL. ..REPOETS

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