Background The second wave of COVID-19 pandemic has seen an unprecedented rise in the number of mucormycosis cases worldwide and in India particularly. This otherwise rare fungal infection has become an endemic among patients who have recovered from recent SARS-CoV-2 infection. Among the different types of mucormycosis, rhino-orbital-cerebral involvement has mainly been observed in the recent surge of cases. Very few cases of mucormycosis of mandible have been reported in literature and none in COVID-19 patients. We report a case of isolated mandibular mucormycosis in a COVID- 19 patient, with no other predisposing comorbidities. Case report A 39 year old patient recently recovered from COVID-19 presented with typical symptoms of osteomyelitis which was confirmed using computed tomography of face. He underwent thorough debridement and curettage and tissue was sent for culture, special staining and biopsy. Result Diagnosis of mucormycosis was confirmed based on postoperative biopsy and special staining. He was further managed with complete course of appropriate antifungal therapy. Conclusion Mucormycosis is a fulminant and aggressive infection which requires prompt diagnosis and intervention. Early referral to a maxillofacial surgeon by physicians and general dental practitioners on seeing signs and symptoms of secondary fungal infections involving maxilla or mandible in patients with history of SARS-CoV-19 infection can improve prognosis.
Study Design: The Coronavirus disease-19 (COVID-19) pandemic has disrupted oral and maxillofacial (OMF) surgeons’ practice globally. We implemented a cross-sectional, questionnaire-based survey among the OMF surgeons of India. Objective: The objectives of the study were (1) gathering data among the maxillofacial surgeons in terms of their occupational exposure and access to adequate personal protective equipment (PPE) and (2) to estimate how the COVID-19 pandemic has affected the practice of OMF surgeons in India. Materials and Methods: Complete responses of 178 OMF surgeons were included in the study. Descriptive and analytic statistics were computed. The level of statistical significance was set at P < 0.05. Binary logistic regression models were created to assess the predictors of the impact of the COVID-19. Results: Out of the 178 respondents of the study, most (37.1%) were following their hospital's guidelines. Most had access to adequate PPE (89.9%), whereas 93.8% had COVID-19 testing available. One hundred and thirty-three (74.7%) surgeons were involved in teleconsultation. Ninety-two (51.7%) and 166 (93.3%) were involved in elective surgery and emergency surgeries, respectively. Median outpatient department cases and number of surgeries done per week reduced by 73.9% and 66.7% (P < 0.001), respectively. Most surgeons (86%) experienced that cost of treatment had increased during the COVID. Over 75% were afraid to get infected with COVID, whereas 44.9% were anxious to lose the income. More than 56% of the OMF surgeons reported a fall in income and 94% reported decreased productivity in academic research. Most surgeons (93.8%) believed that COVID had a positive impact on human behavior in terms of hand hygiene. Conclusion: The impact of COVID-19 among OMF surgeons has adversely affected clinical practice, personal lives, and academic productivity and has catalyzed an exponential increase of telemedicine. Future surveys should capture the long-term impact of COVID-19.
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