Mucormycosis: The Scathing Invader
Mucormycosis is an invasive fungal infection that has been increasing in incidence over the years. Increase in the number of diabetics, malignancy patients, and use of immunosuppressants has mainly led to this gradual upward surge. Mucormycosis has various clinical forms, including rhino-orbito-cere...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | Indian Journal of Dermatology |
| Subjects: | |
| Online Access: | http://www.e-ijd.org/article.asp?issn=0019-5154;year=2021;volume=66;issue=4;spage=393;epage=400;aulast=Vasudevan |
| _version_ | 1818738270932041728 |
|---|---|
| author | Biju Vasudevan Nandita Hazra K P Shijith Shekhar Neema Senkadhir Vendhan |
| author_facet | Biju Vasudevan Nandita Hazra K P Shijith Shekhar Neema Senkadhir Vendhan |
| author_sort | Biju Vasudevan |
| collection | DOAJ |
| description | Mucormycosis is an invasive fungal infection that has been increasing in incidence over the years. Increase in the number of diabetics, malignancy patients, and use of immunosuppressants has mainly led to this gradual upward surge. Mucormycosis has various clinical forms, including rhino-orbito-cerebral, pulmonary, gastrointestinal, and cutaneous. Fungi belonging to Mucorales are thermotolerant and ubiquitous, found growing on organic substrates such as bread, decaying fruits and vegetables, crop debris in soil, compost, and animal excreta. During this second wave of the COVID-19 pandemic, the number of cases of mucormycosis has increased manifold in a short span of time. Associated comorbidity of diabetes mellitus, increased use of higher doses and prolonged duration of systemic corticosteroids, the glucogenic and prothrombotic propensity of the virus, hypoxic environment, COVID pneumonia, increased hospitalization, ICU admissions, and mechanical ventilation have all contributed toward this high rise in numbers. The rhin-orbito-cerebral form is the commonest manifestation of mucormycosis in COVID. Rhizopus oryzae, the main species causing mucormycosis, is identified by hyaline, sparsely-septate, broad, ribbon-like hyphae with irregular right-angle branching ribbon-like hyphae with rhizoids. For the early diagnosis of this infection, 10% KOH mount is very important. These fungi are very rapidly growing and thus can be differentiated from their main ally, Aspergillus. Treatment is mainly in the form of extensive surgical debridement along with liposomal amphotericin B. Posaconazole and isavuconazole are second-line agents, which can also be used for maintenance. Control of diabetes and COVID-19, along with judicious use of antibiotics and systemic corticosteroids, are equally important as management strategies in these pandemic times. |
| first_indexed | 2024-12-18T01:06:17Z |
| format | Article |
| id | doaj.art-40701d6554734a34aa174416f9c8a828 |
| institution | Directory Open Access Journal |
| issn | 0019-5154 1998-3611 |
| language | English |
| last_indexed | 2024-12-18T01:06:17Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Dermatology |
| spelling | doaj.art-40701d6554734a34aa174416f9c8a8282022-12-21T21:26:13ZengWolters Kluwer Medknow PublicationsIndian Journal of Dermatology0019-51541998-36112021-01-0166439340010.4103/ijd.ijd_477_21Mucormycosis: The Scathing InvaderBiju VasudevanNandita HazraK P ShijithShekhar NeemaSenkadhir VendhanMucormycosis is an invasive fungal infection that has been increasing in incidence over the years. Increase in the number of diabetics, malignancy patients, and use of immunosuppressants has mainly led to this gradual upward surge. Mucormycosis has various clinical forms, including rhino-orbito-cerebral, pulmonary, gastrointestinal, and cutaneous. Fungi belonging to Mucorales are thermotolerant and ubiquitous, found growing on organic substrates such as bread, decaying fruits and vegetables, crop debris in soil, compost, and animal excreta. During this second wave of the COVID-19 pandemic, the number of cases of mucormycosis has increased manifold in a short span of time. Associated comorbidity of diabetes mellitus, increased use of higher doses and prolonged duration of systemic corticosteroids, the glucogenic and prothrombotic propensity of the virus, hypoxic environment, COVID pneumonia, increased hospitalization, ICU admissions, and mechanical ventilation have all contributed toward this high rise in numbers. The rhin-orbito-cerebral form is the commonest manifestation of mucormycosis in COVID. Rhizopus oryzae, the main species causing mucormycosis, is identified by hyaline, sparsely-septate, broad, ribbon-like hyphae with irregular right-angle branching ribbon-like hyphae with rhizoids. For the early diagnosis of this infection, 10% KOH mount is very important. These fungi are very rapidly growing and thus can be differentiated from their main ally, Aspergillus. Treatment is mainly in the form of extensive surgical debridement along with liposomal amphotericin B. Posaconazole and isavuconazole are second-line agents, which can also be used for maintenance. Control of diabetes and COVID-19, along with judicious use of antibiotics and systemic corticosteroids, are equally important as management strategies in these pandemic times.http://www.e-ijd.org/article.asp?issn=0019-5154;year=2021;volume=66;issue=4;spage=393;epage=400;aulast=Vasudevanamphotericin bcovid-19cutaneousmucormycosisrhino-orbito-cerebralrhizopus |
| spellingShingle | Biju Vasudevan Nandita Hazra K P Shijith Shekhar Neema Senkadhir Vendhan Mucormycosis: The Scathing Invader Indian Journal of Dermatology amphotericin b covid-19 cutaneous mucormycosis rhino-orbito-cerebral rhizopus |
| title | Mucormycosis: The Scathing Invader |
| title_full | Mucormycosis: The Scathing Invader |
| title_fullStr | Mucormycosis: The Scathing Invader |
| title_full_unstemmed | Mucormycosis: The Scathing Invader |
| title_short | Mucormycosis: The Scathing Invader |
| title_sort | mucormycosis the scathing invader |
| topic | amphotericin b covid-19 cutaneous mucormycosis rhino-orbito-cerebral rhizopus |
| url | http://www.e-ijd.org/article.asp?issn=0019-5154;year=2021;volume=66;issue=4;spage=393;epage=400;aulast=Vasudevan |
| work_keys_str_mv | AT bijuvasudevan mucormycosisthescathinginvader AT nanditahazra mucormycosisthescathinginvader AT kpshijith mucormycosisthescathinginvader AT shekharneema mucormycosisthescathinginvader AT senkadhirvendhan mucormycosisthescathinginvader |