Rhino-orbito-cerebral mucormycosis: An epidemic within a global pandemic

Dr Ajay M Bhandarkar, Associate Professor

Year : 2021 | Volume : 4 | Issue : 1 | Page : 1 | DOI -10.46319/RJMAHS.2021.v04i01.001

Emergence of coronavirus disease-19 and mucormycosis:
222 countries and more than 170 million confirmed cases of corona virus disease (COVID 19) and 3 million deaths has sparked a fear among the masses in the year 2020-2021.[1] It is responsible for a severe lower respiratory infection culminating in acute respiratory distress syndrome (ARDS) in a matter of 2 to 3 weeks. Although the case fatality rate is low, it can cause severe debilitating illness with prolonged mechanical ventilation and hospital stay in vulnerable individuals. COVID 19 has refused to cease with its recurrent mutations and treatment related complications. Rhino-orbito-cerebral mucormycosis (ROCM) is one such complication, which has seen an emergence with large number of cases being reported lately. The estimated prevalence of mucormycosis in India is said to be around 70 times higher than the overall global data.[2]
Predisposing factors
Mucormycosis is an invasive fungal disease caused by a peculiar group of fungi belonging to the genus Mucorales, which is commonly found in the soil and environment. The spores are usually inhaled and could be present as commensals in the human body. The triggers for the florid manifestations of mucor are the immunocompromised state, namely, diabetes mellitus, chemotherapy, organ transplant, steroid use and HIV. It is uncommon in immunocompetent individuals.
Mucormycosis has an affinity for multiple organs. COVID associated Mucormycosis has been classified as per the site into: ROCM, pulmonary mucormycosis, gastrointestinal mucormycosis and disseminated mucormycosis. ROCM has been observed to have a mortality rate of above 50%.