How COVID-19 Impacted on Rhino-Orbital-Cerebral Mucormycosis

Practice Guideline on Prevention, Diagnosis, and Treatment of Rhino-Orbito-Cerebral Mucormycosis in the COVID-19 Area: A Consensus of Iranian Experts

“…The other causes of mortality among these patients are secondary bacterial and fungal infections (2)(3)(4). Mucormycosis gained much attention in the ongoing COVID-19 pandemic (2,5,6). A rise in the frequency of COVID-19associated mucormycosis (CAM) occurred in 2020 and 2021 (2,5,7,8).…”

“…Mucormycosis gained much attention in the ongoing COVID-19 pandemic (2,5,6). A rise in the frequency of COVID-19associated mucormycosis (CAM) occurred in 2020 and 2021 (2,5,7,8).…”

“…Overall, the mortality rate of ROCM has been reported to be between 54% and 75% (2,9). Rhino-orbitocerebral mucormycosis and pulmonary mucormycosis are mostly observed in patients with uncontrolled diabetes mellitus (DM) or immunosuppressive conditions (2,5,7,9). Pulmonary mucormycosis may develop most commonly in patients with profound neutropenia and graft-versushost disease (GVHD) (14).…”

“…Upon suspicion of a CAM case, good communication and close collaboration between clinicians and the microbiology laboratory is essential to ensure that all steps of the diagnostic procedure are being taken properly. COVID-19associated mucormycosis diagnosis is based on a combination of clinical manifestations, compatible imaging findings, and laboratory findings (Figure 1) (5,9,(18)(19)(20).…”

“…Orbital exenteration can be considered in cases when vision decreases to no light perception and loss of eye movements, along with extensive necrosis, especially in the orbital apex. Intra-orbital injection of amphotericin is a new and promising approach that may be helpful in a group of patients with orbital involvement (5,61). Liposomal amphotericin is associated with less inflammation of the orbit after injection (40).…”