Rhino-Orbito-Cerebral Mucormycosis - A Retrospective Review of 246 Cases for Clinicoradiological Sites of Predilection

Neelima G*

Department of ENT, UCMS and GTB Hospital, Delhi, India

^*Correspondance to: Neelima G 

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Abstract:

Aim: To determine the sites of predilection of the rhino-orbito-cerebral mucormycosis, an otherwise rare and opportunistic infection. Methods: The study was a retrospective review of 246 patients of microbiologically confirmed mucormycosis from April 2021 to October 2021 were included in the study. Observations: Among the 234 patients who could undergo radiological assessment of extent of disease, 51 (21.79%) had sinonasal disease, 110 (47.01%) had rhino-orbital disease, 12 (5.13%) had rhino-cerebral disease and 61 (26.07%) had rhino-orbito-cerebral disease at presentation. At the time of presentation, 53 (21.54%) tested positive for COVID-19. Most common comorbidity found was diabetes mellitus (n=200, 81.3%) followed by anemia (n=171, 69.51%). Most common presenting complaint was eyelid swelling (n=153, 62.2%) followed by cheek swelling (n=124, 50.41%). Most common finding on diagnostic nasal endoscopy was black crusts (n=177, 71.95%) and mucopurulent secretions (n=133, 54.07%). Rhizopus was identified in culture in 113 (45.93%) as the most common causative agent. Cunninghamella (n=6, 2.44%), Lichtheimia (n=1, 0.41%) was also found. Median (IQR) of hospital stay was 37.5 (41.5) days during which 79 (32.11%) patients expired. Conclusion: Maxillary sinus was the most common site involved followed by the ethmoid air cells. We observed that the key to a better prognosis was early identification and aggressive treatment involving surgical debridement and intravenous amphotericin B.

Keywords:

Mucormycosis; COVID-19; Mucorales; Rhino-orbito-cerebral

Cite the Article:

Neelima G. Rhino-Orbito-Cerebral Mucormycosis - A Retrospective Review of 246 Cases for Clinicoradiological Sites of Predilection. Ann Clin Case Rep. 2023; 8: 2489..