Managing COVID-19 Associated Mucormycosis: When a Fungal Attack Went Viral! (2022 AMW)
2022 AAO-HNSF Annual Meeting & OTO Experience
The session will focus on identifying, diagnosing and treating Rhino-orbitocerebral Mucormycosis (ROCM), especially its varied presentations and disease characteristics in the current COVID-19 era. India has borne witness to the highest caseload of COVID-19 associated Mucormycosis (CAM) across the globe, of which ROCM was the commonest presentation. Guidelines on managing ROCM have been scarce and inadequate in the past owing to paucity of evidence on this disease entity. Thus, we wish to present our clinical and administrative experience and data from India with an aim of guiding clinicians across the world in early identification, prompt diagnosis and initiation of appropriate surgical and medical management of CAM. In the pre-COVID-19 era, ROCM presented as a rapidly progressive, potentially fatal condition, with high morbidity and mortality (60-80%). During the COVID-19 pandemic, multiple factors attributed to the sudden surge in CAM cases, most importantly, indiscriminate use of steroids, the cellular milieu created by COVID-19 itself - acidosis, hyperglycemia, hyperferritinemia and immunosuppression; and high prevalence of pre-diabetics in the Indian population. The clinico-radiological characteristics of CAM were found to be different from classical ROCM in many ways, posing challenges in early diagnosis. The symposium will consist of lectures and discussion on the unique behaviour of CAM vis a vis classical ROCM, diagnostic modalities, surgical principles and extent of debridement, dose and duration of antifungal therapy, choosing the correct antifungal and managing the underlying comorbid conditions. The role of adjunctive and hitherto unexplored treatment modalities such as Transcutaneous retrobulbar Amphotericin-B (TRAMB) injection shall also be discussed.
Credits
CME:1.0, MOC:1.0