Mucormycosis in an Immunocompetent Patient Recovering From Dengue Fever.

Mucormycosis is a rare yet aggressive fungal infection. Despite its rarity, India has experienced a surge in cases during the post-COVID-19 era. The high mortality rate associated with this infection necessitates early diagnosis, intervention, and aggressive treatment. Typically, it is observed in immunocompromised patients, where the disease progresses rapidly and leads to unfavorable outcomes. However, occurrences in previously healthy individuals are not uncommon. Dengue has been occasionally associated with mucormycosis in the post-recovery phase. This case report highlights the importance of heightened clinical suspicion and early intervention in patients with recent dengue infections and chronic sinus conditions. It explores potential risk factors, such as dengue-related immune alterations, environmental exposures, and anatomical alterations that may contribute to the development of mucormycosis in otherwise healthy individuals.

Posterior Ethmomaxillary Cells: Anatomical Variation to be Considered in Endoscopic Sinus Surgery.

To identify the posterior ethmomaxillary (PEM) cells on computed tomographic scans for complete sinus clearance during endoscopic sinus surgery to prevent disease recurrence. Prospective single institution study. MAA ENT Hospitals Pvt. Ltd., Hyderabad. 350 patients were selected for the study. Computed tomographic scans of these patients were performed suffering from chronic rhinosinusitis and requiring endoscopic sinus surgery (primary or revision cases). The scans were evaluated and presence of PEM cells was noted. These findings were co-related intra-operatively and above-mentioned cells were opened. In revision cases, these cells were left unopened in previous cases and were cleared in present surgery and the patients were followed up for recurrence. A total number of 350 CT scans of nose and para-nasal sinus were studied. There were 176 males and 174 were females. The presence of PEM cells was 11.42% with bilaterality in 80%. In revision cases, it was 23%. PEM cells act as hidden areas in the para-nasal sinus and if not identified and cleared, it acts as a nidus for disease recurrence and cause for failure of surgery. Identification of PEM is important during surgery for complete disease clearance. As very little information exists in the current literature, we are submitting this study to enlighten Rhinologist regarding PEM cells.