Assuntos
COVID-19 , Infecções Oculares Fúngicas , Mucormicose , Oclusão da Artéria Retiniana , SARS-CoV-2 , Humanos , COVID-19/complicações , COVID-19/diagnóstico , Mucormicose/diagnóstico , Mucormicose/complicações , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/microbiologia , Oclusão da Artéria Retiniana/etiologia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/complicações , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/microbiologia , Doenças Orbitárias/etiologiaRESUMO
Rhino orbital Mucormycosis caused by filamentous fungus of mucoraceae family was considered a rare disease affecting immunocompromised and diabetics with ketoacidosis until the recent COVID 19 pandemic. We are presenting a series of six cases of Rhino orbital cerebral Mucormycosis with central retinal artery occlusion. All six cases had common history of COVID 19 infection in recent past with sinusitis, proptosis and total ophthalmoplegia with central retinal artery occlusion on presentation. MR imaging showed invasive pan sinusitis with orbital and cerebral involvement. Urgent debridement was done and histopathological examination showed broad, filamentous aseptate fungi suggestive of Mucormycosis. All patients inspite of intravenous Amphotericin B with local debridement did not show any improvement and expired within a week of presentation. Hence our study shows poor prognosis of post covid 19 associated Mucormycosis with central retinal artery occlusion.
Assuntos
COVID-19 , Mucormicose , Doenças Orbitárias , Oclusão da Artéria Retiniana , Sinusite , Humanos , Mucormicose/complicações , Mucormicose/diagnóstico , Mucormicose/terapia , Doenças Orbitárias/diagnóstico , Doenças Orbitárias/etiologia , Doenças Orbitárias/terapia , COVID-19/complicações , Sinusite/complicações , Sinusite/diagnóstico , Sinusite/terapia , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/etiologiaRESUMO
A middle aged woman presented to us with a localised well defined swelling of 3 months duration. It was located just below the lower eyelid punctum and was constantly discharging whitish granules. We suspected it to be arising from the lacrimal apparatus and posted the patient for Dacryocystectomy. On the operating table we found a swelling in the region of the lacrimal sac which was later excised. Histopathology revealed Botryomycosis and Chronic Dacryocystitis. Botryomycosis is a rare condition and requires a high index of suspicion to diagnose it. It is confirmed by histopathology and culture. Surgical debridement is the treatment of choice in such cases with an assessment of the immune status. Long term antibiotic treatment is required in all conditions as recurrence is common.
