UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY, 2021
BACKGROUND
Mucormycosis (Black fungus) is a designated as a
rare, rapidly progressive fatal disea... more BACKGROUND Mucormycosis (Black fungus) is a designated as a rare, rapidly progressive fatal disease of immunocompromised caused by saprophytic fungus of family mucorales. Early diagnosis with prompt medical and surgical treatment is the only tool available. Rhino-orbito-cerebral is the most common subtype. In India we saw a sudden rise in mucormycosis cases during second wave of COVID 19. This necessitated a systematic review of epidemic of mucormycosis in COVID 19. METHODS A Retrospective multi-centric study was conducted at various Government and Private Hospitals of Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent COVID19 positive status presenting to us during 14th April 2021- 31st May 2021. RESULT Either Type2 Diabetes Mellitus or history of recent use of steroids in high doses was present in all the patients. Contribution of virulence of the Delta strain B1.617.2 is significant. FESS with sino-nasal debridement contributes significantly towards mortality reduction and cost of total treatment by significantly reducing days of Liposomal Amphotericin B therapy. CONCLUSION Early diagnosis with prompt medical and surgical management along with blood sugar control and avoiding use of high dose of steroids remain to key to mortality and morbidity reduction.
CT Scans use a narrow X-Ray beam that circles around the part of body to be scanned. The data is ... more CT Scans use a narrow X-Ray beam that circles around the part of body to be scanned. The data is transmitted to a computer, which build up 3D cross sectional picture. Although CT Scans cannot distinguish between inflammation and infection, they correlate with extent of disease. CT Scans have been very useful in assessing severity of the disease or response to treatment in chronic Rhinosinusitis. It is also the most reliable radiological examination to identify a fungus ball. The latest CT machines allow a complete set of axial slices to be made within a few seconds. The CT scan proved to be an excellent imaging tool as it can accurately diagnose & differentiate benign & malignant lesions, can describe the masses in terms of their origin, nature, extension, & involvement. Computerized tomography (CT) is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery (FESS). CT has some medico-legal importance as well. This is a prospective study conducted on 30 patients (from September 2018 to May 2019). Both male and female patients of different age groups with clinically suspected PNS diseases were enrolled for the study. Both axial and coronal images were acquired using multi-detector CT unit. The paranal sinuses were evaluated for: mucosal thickening, wall of sinus, fluid level, soft tissue extension, hyperdensities and masses, blockage of osteomeatal complex, and pattern of bony involvement. There was a male predominance of 54% as compared to females 46%. The chief presenting complaint was of nasal obstruction (49%), followed by a headache (40.8%), nasal discharge (30.5%), facial pain (20%), and others (37.7%). The most common CT diagnosis was chronic sinusitis (13/30) followed by polyp (7/30) and fungal sinusitis (5/30). In this study, maxillary sinus (83.5%) was the most commonly involved sinus followed by ethmoid sinus (74.7%), sphenoid sinus (43.9%), and frontal sinus (54.9%). CT was able to characterize the PNS diseases along with their extension. It could also delineate the bony involvement of PNS diseases. CT may be used as gold standard imaging modality for evaluating the Paranasal Sinus diseases. Keywords: Paranasal sinus pathology, Chronic sinusitis, Headache, Computed tomography.
UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY, 2021
BACKGROUND
Mucormycosis (Black fungus) is a designated as a
rare, rapidly progressive fatal disea... more BACKGROUND Mucormycosis (Black fungus) is a designated as a rare, rapidly progressive fatal disease of immunocompromised caused by saprophytic fungus of family mucorales. Early diagnosis with prompt medical and surgical treatment is the only tool available. Rhino-orbito-cerebral is the most common subtype. In India we saw a sudden rise in mucormycosis cases during second wave of COVID 19. This necessitated a systematic review of epidemic of mucormycosis in COVID 19. METHODS A Retrospective multi-centric study was conducted at various Government and Private Hospitals of Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent COVID19 positive status presenting to us during 14th April 2021- 31st May 2021. RESULT Either Type2 Diabetes Mellitus or history of recent use of steroids in high doses was present in all the patients. Contribution of virulence of the Delta strain B1.617.2 is significant. FESS with sino-nasal debridement contributes significantly towards mortality reduction and cost of total treatment by significantly reducing days of Liposomal Amphotericin B therapy. CONCLUSION Early diagnosis with prompt medical and surgical management along with blood sugar control and avoiding use of high dose of steroids remain to key to mortality and morbidity reduction.
CT Scans use a narrow X-Ray beam that circles around the part of body to be scanned. The data is ... more CT Scans use a narrow X-Ray beam that circles around the part of body to be scanned. The data is transmitted to a computer, which build up 3D cross sectional picture. Although CT Scans cannot distinguish between inflammation and infection, they correlate with extent of disease. CT Scans have been very useful in assessing severity of the disease or response to treatment in chronic Rhinosinusitis. It is also the most reliable radiological examination to identify a fungus ball. The latest CT machines allow a complete set of axial slices to be made within a few seconds. The CT scan proved to be an excellent imaging tool as it can accurately diagnose & differentiate benign & malignant lesions, can describe the masses in terms of their origin, nature, extension, & involvement. Computerized tomography (CT) is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery (FESS). CT has some medico-legal importance as well. This is a prospective study conducted on 30 patients (from September 2018 to May 2019). Both male and female patients of different age groups with clinically suspected PNS diseases were enrolled for the study. Both axial and coronal images were acquired using multi-detector CT unit. The paranal sinuses were evaluated for: mucosal thickening, wall of sinus, fluid level, soft tissue extension, hyperdensities and masses, blockage of osteomeatal complex, and pattern of bony involvement. There was a male predominance of 54% as compared to females 46%. The chief presenting complaint was of nasal obstruction (49%), followed by a headache (40.8%), nasal discharge (30.5%), facial pain (20%), and others (37.7%). The most common CT diagnosis was chronic sinusitis (13/30) followed by polyp (7/30) and fungal sinusitis (5/30). In this study, maxillary sinus (83.5%) was the most commonly involved sinus followed by ethmoid sinus (74.7%), sphenoid sinus (43.9%), and frontal sinus (54.9%). CT was able to characterize the PNS diseases along with their extension. It could also delineate the bony involvement of PNS diseases. CT may be used as gold standard imaging modality for evaluating the Paranasal Sinus diseases. Keywords: Paranasal sinus pathology, Chronic sinusitis, Headache, Computed tomography.
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Mucormycosis (Black fungus) is a designated as a
rare, rapidly progressive fatal disease of
immunocompromised caused by saprophytic
fungus of family mucorales. Early diagnosis with
prompt medical and surgical treatment is the only
tool available. Rhino-orbito-cerebral is the most
common subtype. In India we saw a sudden rise in
mucormycosis cases during second wave of
COVID 19. This necessitated a systematic review of
epidemic of mucormycosis in COVID 19.
METHODS
A Retrospective multi-centric study was conducted
at various Government and Private Hospitals of
Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent
COVID19 positive status presenting to us during
14th April 2021- 31st May 2021.
RESULT
Either Type2 Diabetes Mellitus or history of recent
use of steroids in high doses was present in all the
patients. Contribution of virulence of the Delta
strain B1.617.2 is significant. FESS with sino-nasal
debridement contributes significantly towards
mortality reduction and cost of total treatment by
significantly reducing days of Liposomal
Amphotericin B therapy.
CONCLUSION
Early diagnosis with prompt medical and surgical
management along with blood sugar control and
avoiding use of high dose of steroids remain to key
to mortality and morbidity reduction.
Keywords: Paranasal sinus pathology, Chronic sinusitis, Headache, Computed tomography.
Mucormycosis (Black fungus) is a designated as a
rare, rapidly progressive fatal disease of
immunocompromised caused by saprophytic
fungus of family mucorales. Early diagnosis with
prompt medical and surgical treatment is the only
tool available. Rhino-orbito-cerebral is the most
common subtype. In India we saw a sudden rise in
mucormycosis cases during second wave of
COVID 19. This necessitated a systematic review of
epidemic of mucormycosis in COVID 19.
METHODS
A Retrospective multi-centric study was conducted
at various Government and Private Hospitals of
Western UP comprising of 51 cases of Rhino-orbitocerebral mucormycosis with present or recent
COVID19 positive status presenting to us during
14th April 2021- 31st May 2021.
RESULT
Either Type2 Diabetes Mellitus or history of recent
use of steroids in high doses was present in all the
patients. Contribution of virulence of the Delta
strain B1.617.2 is significant. FESS with sino-nasal
debridement contributes significantly towards
mortality reduction and cost of total treatment by
significantly reducing days of Liposomal
Amphotericin B therapy.
CONCLUSION
Early diagnosis with prompt medical and surgical
management along with blood sugar control and
avoiding use of high dose of steroids remain to key
to mortality and morbidity reduction.
Keywords: Paranasal sinus pathology, Chronic sinusitis, Headache, Computed tomography.