Mucormycosis???

-55 M -Post COVID Status -No comorbids -He was admitted to hospital & was on O2 for more than a week -Now pt is on T.Rivaroxaban 10 mg OD -Now after 2 weeks he has developed such black lesions on the lips which bleeds on peeling -Pt. Feels like the lesion is extending on the lips -Could this be Mucormycosis or is it a drug reaction caused by Rivaroxaban or any other drugs -Awaiting your valuable opinions...

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Patient do not have comorbidity Was on O2 inhalation & admitted Possibilities of high dose steroids used, dose of steroids not mentioned In picture it is seen black necrosed tissue confined to lips, no other complaints as such So it is very difficult to say if it is Mucormycosis or drug induced(? Doxycycline) As Mucormycosis is very dreadful disease, early treatment is highly recommend Start with Pisaconanazol 100mg tds Ready to get Amphotericin B injection Simultaneously confirm the diagnosis by taking tissue in KOH If still steroids is on, stop judiciously Antiallergic Safe antibiotics Do D-DIMER, PT with INR to asses if further requirement of Rivaroxaban

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Dear Dr. Rajiv Kumar Timur Sir, Advice for the case by Ayurveda. Continue your treatment and may add Tab. Arkadi Vati 1tds. Advice for Goghruta Pratimarsh Nashyam. Advice for Dhumpan by Ayurvedic method.Advice for Kawal Dharan with Irimedadi tail. Avoid atmosphere with moisture. Do Dopan Karma.

Mucormycosis Ad Inj Amphotrecin B Candid tab 200 mg daily Multifungin oint locally Levocet sos

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NEED'S.. HISTOPATHOLOGICAL STUDY.. PROMT .. ANTIFUNGAL TREATMENT..

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MUCORMYCOSIS presenting as crusted lesion Lips

Lab test to cnf Black fungus and also rpt Blood sugar . Seems Black Fungal infection.

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HPE study Biopsy Rx Dual therapy Amphotericin b inj stat +Tab.pasaconazole 300mg BD 1st day Tab.pasaconazole 300mg OD for 2_3 weeks

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It's definitely Drug induced skin reaction to Rivaroxaban,if it's Mucormycosis the focal point of infection is innerside of both Nasal Sinuses & Nasal bones,the spread is Rapid & patients become serious with in 1weak.DrRajeshwerrao.karimnagar T.S.

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