<p class="abstract">Rhino-orbital-cerebral mucormycosis is an invasive disease associated with high mortality ranging from 25-62%. There is an increase in the incidence of mucormycosis in post COVID-19 infection patients. We have come across 10 such patients. On retrospective analysis of the patient’s records, we found that 60% patients had received steroids and majority had co-morbidities. All the patients received similar treatment with IV amphotericin B and local debridement and the mortality rate was as high as 44%. We conclude that patients with COVID 19 infection are susceptible to mucormycosis because of impairment of barrier defense, dysfunction phagocytes and lymphocytes and the use of immunosuppressive medications such as steroids and tocilizumab.</p>
This retrospective study describes practical experience in the management of this rare and severe disease in a referral centre for cystic fibrosis lung transplantation. Voriconazole and caspofungin combination was acceptably safe and was associated with good clinical outcomes in almost all patients. We showed that in 15 lung-transplant recipients a median of 12.3 days was required for voriconazole to reach high enough blood levels. Caspofungin in combination with voriconazole provides cover against Aspergillus infection during the period when voriconazole may be at subtherapeutic levels with good tolerability.
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