RESUMEN
COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral presentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis.
RESUMEN
Physicians should be cognizant of the multitude of unique issues that their geriatric patients present and aware of the overall elder patient's general health status both physically and cognitively, potential drug interactions, and their short-term as well as long-term goals. While respecting patients' autonomy, we must evaluate their ability to make their own decisions regarding their health care. This will require time and patience on our part. We also must overcome our own potential prejudices about what we view as important for the older patient. Finally, we may need to appropriate involve family members or caregivers in the decision-making processes and care of our elderly patients. To properly and ethically care for this distinct and vulnerable population, with their myriad of complex issues, it is important that dermatologists understand their unique issues and challenges.