Concluded Case

MUCORMYCOSIS

Excessive steroids and high use of oxygen can lead to black fungus or MUCORMYCOSIS!! The fungus invades the sinus and makes it's way into the intraorbital and intracranial regions. If it's progression is not checked early, 50-80% of patients could die. MOST COMMONLY SEEN IN RECOVERED AND RECOVERING COVID PATIENTS Mucormycosis is a very rare infection. It is caused by exposure to mucor mould is commonly found in soil,plants,manure and decaying fruits and vegetables. It is ubiquitous and found in soil and air , even in the nose & mucus of healthy people. Steroids reduce inflammation in the lungs for covid19 but they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic covid19 patients. It's thought that this drop in immunity could be triggering these cases of mucormycosis. Risk of mucormycosis infection. 1) Uncontrolled diabetes 2)Weakening of immune system due to use of steroids 3) Prolonged ICU/HOSPITAL STAY 4)CO-morbidities/ post organ transplant/ cancer 5)Voriconazole therapy ( used to treat serious fungal infections) Symptoms: ●Pain or redness around the eyes ●Fever ●Headache ●Coughing ●Shortage of breath ●Bloody vomit ●Altered mental status. How to prevent:- DO'S ●Control Hyperglycemia ●Monitor blood glucose level post covid19 discharge ●Use steroids judiciously ●Use sterile water for humidifiers during oxygen therapy ●Use antibiotics/antifungals judiciously DONT'S ●Do not miss warning signs and symptoms ●Do not consider all the cases with blocked nose as cases of bacterial sinusitis , particularly in the context of immunisuppression or covid19 patients on immunomodulators. ●Do not hesitate to seek aggressive investigations as appropriate (KOH staining & microscopic culture , MALDITOF) for detecting fungal ecology.

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Good case presentation Yes i agree red flags are to be detected earliest can prevent disasters and tragedies As available treatment is only amphotercinB very toxic and lengthy therapy Yes follow DOs and Don'ts will help to prevent it

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Good case presentation Yes i agree red flags are to be detected earliest can prevent disasters and tragedies As available treatment is only amphotercinB very toxic and lengthy therapy Yes follow DOs and Don'ts will help to prevent it

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Very good presentation

Thank you doctor
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Yes excessive inhaling is the cause

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