A Study on Management of Mucormycosis - Comparative Study Between Multiple Staged Surgical Procedures and Single Surgical Procedure in a Tertiary Care Centre

Abstract

Background Mucormycosis is an invasive fungal infection most commonly affecting immuno-compromised individuals. It is a rapidly progressive, life threatening infection. Objective To study the various treatment modalities and their outcome Method In this study we retrospectively and prospectively investigate 37 patients of rhino-maxillary/ rhino-orbital/ rhino-cerebral mucormycosis between January 2016 and September 2017. We analysed the risk factors, clinical features, histopathological reports, radiological investigation and treatment (medical and surgical-Multiple staged surgical procedures and Single stage procedure) along with the outcome. We compared multiple staged surgeries with single debridement and followed up the patient till October 2017. Results Diabetes was the single most important risk factor (31 patients)-of which the recent status of glycemic control was the most contributing factor. Other risk factors included-electrolyte imbalance, anaemia and deranged renal parameters. Out of 23 patients treated with multiple staged surgeries, 29 were free of disease, 2 lost to follow up and 1 died. Out of 11 patients treated with single surgical procedure, 5 were cured, 3 lost to follow up and 3 were dead (2 due to other reasons). The 3 patients who weren't operated died within 2 weeks. Conclusion Multiple staged surgical procedures proved to have a much better prognosis compared to a single staged procedure.