Surgical management of COVID-19 associated Mucormycosis with adjuvant systemic antifungal therapy

Abstract

Purpose This study aimed to evaluate clinically and radiographically the patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis managed with surgery and simultaneous systemic antifungal therapy. Patients and methods This is an interventional study included 20 cases with COVID-19-associated mucormycosis and they were managed with aggressive surgical debridement and systemic antifungal therapy after controlling of underlying systemic disease. the patients were followed clinically and computed tomography scan for 6 months. Results The cases were with only nasal/sinus involvement in 15 (75%) cases followed by two (10%) cases with rhino-orbital, and rhino-orbito-cerebral was seen in three (15%) patients, with reported mortality rates of about 10% (two cases). All cases had a history of taking steroids for COVID treatment. All patients had diabetes mellitus with high glucose levels except one case had heart disease. After 6 months, all patients had adequate soft tissue healing with normal color and texture without any signs of recurrence of infection. Computed tomography scan showed adequate bone healing without any evidence of recurrence of disease. Conclusion The diagnosis of mucormycosis should be done early. Aggressive surgical debridement with simultaneous systemic antifungal therapy is necessary for adequate management of disease.