Code Mucor: Guidelines for the Diagnosis, Staging and Management of Rhino-Orbito-Cerebral Mucormycosis in the Setting of COVID-19

COVID-19 associated mucormycosis: the urgent need to reconsider the indiscriminate use of immunosuppressive drugs

“…The therapeutic approach during the COVID-19 pandemic should consider existing guidelines for mucormycosis management, such as those proposed by the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. 50 Specific guidelines in the context of COVID-19 are needed, 51 and new and updated COVID-19 guidelines should also include CAM as a diagnostic consideration. 52 Upon suspicion of mucormycosis, appropriate imaging is strongly recommended to document the extent of the disease followed by a surgical assessment for debridement.…”

COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee)

“…Any patient, either in the acute phase of COVID-19 or in the post-COVID-19 phase, presenting with visual deterioration, periorbital swelling, proptosis, facial pain or numbness, headache, nasal obstruction or nasal bleed must be dealt with a high index of suspicion; neurological manifestations in the form of encephalopathy, focal neurological deficit or seizures may also be seen. 16 , 23 , 24 …”

“…If a biopsy is not possible, nasal scrapping and high nasal swabs should be used for direct examination; though high nasal swab and discharges are unreliable as the yield is low in microscopy and cultures. 16 In case of sinusitis, sinus biopsies must be taken. It is prudent to collect the specimen before initiating antifungal therapy as the morphological features may be altered, reducing the ability to definitively differentiate mucorales species from other filamentous fungi in microscopy.…”

“…A proposal reviewed in light of extant global guidelines for the diagnosis and management of Mucormycosis appeared suitable for application as it followed the most commonly used methods for diagnostic categorisation. 16 , 25 The diagnostic categories may, therefore, be summarized as follows:…”

Mucor Alert: Triad of COVID-19, Corticosteroids Therapy and Uncontrolled Glycemic Index

“…Development of nasal obstruction, nasal crusting, foul or bloody nasal discharge, unilateral facial or orbital pain, facial palsy, facial numbness, blackening of nose or cheek, headache, toothache, loosening of tooth, palatal eschar, periorbital swelling, diplopia, blurred vision, ptosis, proptosis, reduced vision, focal seizures [ 27 ].…”