{"id":447,"date":"2024-02-26T12:32:16","date_gmt":"2024-02-26T12:32:16","guid":{"rendered":"https:\/\/internationaljournalofmicrobialscience.com\/?page_id=447"},"modified":"2024-02-26T12:32:16","modified_gmt":"2024-02-26T12:32:16","slug":"full-text-21","status":"publish","type":"page","link":"https:\/\/internationaljournalofmicrobialscience.com\/index.php\/full-text-21\/","title":{"rendered":"Full-Text"},"content":{"rendered":"

Mucormycosis is due to pathogens from order Mucorales and is accompanied by high mortality and morbidity [1]. Its prevalence in India is approximately 70 times higher than that in the world [1]. The major risk factors are diabetes mellitus, hematological malignancy, and solid-organ transplant [1]. In India, patients suffering from post-pulmonary tuberculosis and chronic kidney disease have more threat of mucormycosis [1]. Cutaneous mucormycosis can occur after trauma [1 of lower immunity owing to COVID-19 treatment. Isolated renal mucormycosis in an immune-competent host is unusual in India [1]. Moreover, the most common agent of mucormycosis is Rhizopus arrhizus<\/em> but Rhizopus homothallicus, Rhizopus microsporus,<\/em> and Apophysomyces variabilis<\/em> may contribute to an infection. In contrast, Mucor irregularis, Saksenaea erythrospora,<\/em> and Thamnostylum lucknowense <\/em>have been seldom reported [1]. Mononuclear cells, tissue macrophages, neutrophils, platelets, and natural killer cells are important in host defense mechanisms [2]. To add, immune suppression and neutropenia hinder the host defenses and allow fungal growth [2].<\/p>\n

Unlike COVID-associated pulmonary aspergillosis, patients acquire invasive mucormycosis through SARS COV-2 (mild to moderate) infections [3]. Hyperglycemia is the strongest predisposing factor in patients with undiagnosed or uncontrolled diabetes [3]. Use of corticosteroids in susceptible hosts enhances the growth of Mucorales [3]. COVID-19 associated mucormycosis can be COVID-19-associated (concomitant) or can occur sequentially weeks or months after recovery (sequential) [3]. Early diagnosis and antifungal as well as surgical therapies for mucormycosis are urgently required for survival of patients [3].<\/p>\n

In individuals with early-stage or mild COVID-19 infection, mucormycosis can be prevented by limiting steroid usage [4]. The recommended corticosteroids for hyperimmune stage of coronavirus infection comprise methylprednisolone, predsolone, dexamethasone, and hydrocortisone [5]. In India, rise in mucormycosis cases appears due to diabetes and non-judicious use of corticosteroids to treat COVID-19[4].<\/p>\n

The Indian Council of Medical Research (ICMR) guidelines for the hospitalized patients with COVID-19 recommended administration of 0.5\u20131 mg\/kg and 1\u20132 mg\/kg methylprednisolone (two divided doses) for patients with moderate and severe diseases, respectively [6]. According to National Institute of Health (NIH) COVID-19 management guidelines, clinicians should manage the patients with COVID-19 who are receiving steroid therapy for adverse effects. The combination of anti-SARS-CoV-2 monoclonal antibodies casirivimab and imdevimab have been granted by Emergency Use Authorization (EUA) by the US Food and Drug Administration for the treatment of non-hospitalized individuals with COVID-19 [7].<\/p>\n

Considering the current situation of COVID-19-associated mucormycosis, attempts to increase awareness, early diagnosis, and treatment must be made and only sensible evidence-based use of corticosteroids in patients with COVID-19 is suggested to diminish the load of deadly mucormycosis.<\/p>\n

Evidence-based medicine can ensure \u201cthe right care at the right time to the right patient\u201d and has a substantial role in saving us in this situation.<\/p>\n","protected":false},"excerpt":{"rendered":"

Mucormycosis is due to pathogens from order Mucorales and is accompanied by high mortality and morbidity [1]. Its prevalence in India is approximately 70 times higher than that in the world [1]. The major risk factors are diabetes mellitus, hematological malignancy, and solid-organ transplant [1]. In India, patients suffering from post-pulmonary tuberculosis and chronic kidney […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-447","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t