Online Registry of COVID-19-Associated Mucormycosis Cases, India, 2021.

We established an online registry of coronavirus disease-associated mucormycosis cases in India. We analyzed data from 65 cases diagnosed during April-June 2021, when the Delta variant predominated, and found that patients frequently received antibacterial drugs and zinc supplementation. Online registries rapidly provide relevant data for emerging infections.

Clinico-Epidemiologic Characteristics of Patients Reported in the Mycotic Infections in COVID-19 Registry.

We update results from the Mycotic Infections in COVID-19 (MUNCO) Registry, May-September 2021. Data collection from May to September 2021 yielded 728 cases from India, Nepal, Bangladesh, Thailand, and the United States. The cases consisted of mostly mucormycosis (97.6%), primarily rhinocerebral, and were analyzed to investigate clinical characteristics associated with negative outcomes. Patients were mostly diabetic (85%) and male (76%), with significant mortality (11.7%). All patients received treatment of coronavirus disease 2019 (COVID-19) as well as antifungal treatment. The crude mortality rate was 11.3% for mucormycosis and 22.7% formixed infections. This study demonstrates the utility of online databases in the collection of high-caliber data.

Factors Associated with Mortality in Coronavirus-Associated Mucormycosis: Results from Mycotic Infections in COVID-19 (MUNCO) Online Registry.

BACKGROUND: COVID-19-associated mucormycosis (CAM) is associated with high morbidity and mortality. MUNCO is an international database used to collect clinical data on cases of CAM in real time. Preliminary data from the Mycotic Infections in COVID-19 (MUNCO) online registry yielded 728 cases from May to September 2021 in four South Asian countries and the United States. A majority of the cases (694; 97.6%) consisted of a mucormycosis infection. The dataset allowed for the analysis of the risk factors for adverse outcomes from CAM and this analysis is presented in this paper. METHODS: The submission of cases was aided by a direct solicitation and social media online. The primary endpoints were full recovery or death measured on day 42 of the diagnosis. All patients had histopathologically confirmed CAM. The groups were compared to determine the contribution of each patient characteristic to the outcome. Multivariable logistic regression models were used to model the probability of death after a CAM diagnosis. RESULTS: The registry captured 694 cases of CAM. Within this, 341 could be analyzed as the study excluded patients with an unknown CAM recovery status due to either an interruption or a lack of follow up. The 341 viable cases consisted of 258 patients who survived after the completion of treatment and 83 patients who died during the period of observation. In a multivariable logistic regression model, the factors associated with an increased risk of mortality include old age (OR = 1.04, 95% CI 1.02-1.07, p = 0.001), history of diabetes mellitus (OR 3.5, 95% CI 1.01-11.9, p = 0.02) and a lower BMI (OR 0.9, 95% CI 0.82-0.98, p = 0.03). Mucor localized to sinus disease was associated with 77% reduced odds of death (OR = 0.23, 95% CI 0.09-0.57, p = 0.001), while cerebral mucor was associated with an increased odds of death (OR = 10.96, 95% CI 4.93-24.36, p = ≤0.0001). CONCLUSION: In patients with CAM, older age, a history of diabetes and a lower body mass index is associated with increased mortality. Disease limited to the sinuses without a cerebral extension is associated with a lower risk of mortality. Interestingly, the use of zinc and azithromycin were not associated with increased mortality in our study.

Amyloid goiter: a case of primary thyroid amyloid disease.

Amyloid goiter is an atypical presentation of an already rare disease, amyloidosis, which uncommonly comes across in previous review of literature. A patient presented with respiratory distress, which aroused a dilemma on diagnosis because the presentation mimicked that of malignancy. A high index of attentiveness should be kept whenever amyloid deposits are seen on fine needle aspiration cytology, as they are also established in medullary carcinoma. Amyloid deposits have been traced in goiter; however, it was astonishing to observe this condition causing a rapidly growing goiter, large enough to cause respiratory distress. The confirmative diagnosis rested on the histopathology of the specimen.

Clinical etiology of myiasis in ENT: a reterograde period--interval study.

UNLABELLED: Myiasis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. AIMS: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence, nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. MATERIALS & METHODS: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. RESULTS & CONCLUSIONS: Atrophic turbinates was the commonest pathological finding in nose in 30% of cases . Significant change seen was in the age group 51 and above with a rise of 30%. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5% . Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.

A rare case of primary nasoethmoidal meningioma.

Meningiomas of sinonasal tract is a rare entity especially in children. Primary sinonasal meningiomas often pose difficulty in diagnosis because of their infrequent occurrence and clinically they appear to be nasal polyp. The final diagnosis rests on the histological examination. Extra cranial meningiomas are rare in children and tend to be more aggressive. Here a case of primary ethmoid sinus meningoma with extension into the nasal cavity is presented and despite of its aggressive behavior it was benign. The importance of complete surgical extirpapion is undoubted and results in a good survival rate. Histological grading of the tumour is not crucial in predicting the rate of recurrence. The paucity of reported cases is the evidence for its rarity.

Bronchial foreign body: A case report.

Exogenous foreign bodies in the tracheo bronchial tree, are not uncommon particularly in children. Children who are not given proper individual attention at an early age are more liable to ingest or inhale foreign body. Complications are related to site, size, shape, nature and duration of foreign body. Foreign body aspiration is associated with significant morbidity. Awareness of these possible complications and a high index of suspicion is the key to successful management. We report a case of bronchial foreign body in a 12 year old boy who had accidentally aspirated a metallic whistle. The foreign body was removed successfullv without any complications.

Nasal glioma : A case report.

Nasal glioma, also known as glial heterptopia or the occurrence of isolated non - leratomatous glial tissue is a rare and benign congenital defect. This condition is diagnosed usually at birth time and requires early treatment to prevent facial deformations. We report here a case of extranasal glioma that was diagnosed and treated at the department of ENT, Gandhi Medical College, Bhopal. We emphasize on the developmental theory proposed as the etiology and discuss the clinical aspects, treatment and follow up.

Clinical etiology of myiasis in ENT: a reterograde period - interval study / Etiologia clínica da miíase em otorrinolaringologia: um estudo retrospectivo

Myiasis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. AIMS: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence, nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. MATERIALS & METHODS: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. RESULTS & CONCLUSIONS: Atrophic turbinates was the commonest pathological finding in nose in 30 percent of cases . Significant change seen was in the age group 51 and above with a rise of 30 percent. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5 percent . Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.

Miíase em ORL não é mais uma doença fatal, mas ainda está presente como um significativo problema em ambientes externos. Entretanto, progressos alcançados no tratamento, incluindo terapêutica de suporte, têm levado à cura precoce com significativa redução na taxa de internação hospitalar por causa dessa enfermidade. OBJETIVOS: Avaliar a etiologia clínica e as associações entre miíase e os hábitos e habitats dos pacientes; e avaliar diferenças no tocante à idade, estação do ano, incidência socioeconômica, flora bacteriana nasal e a utilidade de certos exames comumente feitos - um estudo retrospectivo de 25 anos. MATERIAIS E MÉTODOS: O presente estudo envolveu 80 pacientes selecionados em dois períodos; os primeiros 40 casos foram selecionados de 1979 a 1980, e os 40 seguintes foram coletados entre 2003 e 2004. Os casos foram estudados de forma retrospectiva e os dados foram analisados em tabelas. RESULTADOS E CONCLUSÕES: Cornetos atróficos representaram o achado nasal patológico mais comum - em 30 por cento dos casos. Alterações significativas foram encontradas na faixa etária dos 51 anos e acima, com um aumento de 30 por cento nestes. A média etária entre 2003-04 foi de 60 anos. A incidência de perfuração palatina caiu de 17,88 por cento para 2,5 por cento. Klebsiella foi o germe mais significativamente presente na flora microbiana nasal. Os exames de VDRL e teste cutâneo mostraram pobre associação etiológica entre as doenças.