Therapeutic Outcomes of Mucormycosis Patients: A Retrospective Cohort Study.

Abstract

Introduction: Of all the cases of mucormycosis across the world, India has the largest number, probably because of the large number of uncontrolled diabetes mellitus and its climate, which favors mucormycosis. There is still scarce data in India regarding the duration of treatment required and factors associated with the outcome, such as the extent of disease, glycemic control, hematological, and biochemical parameters. Therefore, this study aims to study any association between the extent of disease and outcome, and the association of hematological and biochemical parameters with the outcome of the disease.

Materials and methods: It was a retrospective cohort study. Study patients were all mucormycosis patients admitted from May 2021 to October 2021 in the Department of Medicine in a tertiary care teaching hospital. Diagnosis was made by direct KOH microscopy, histopathology, or fungal culture from nasal tissue. Patients who showed mixed infections or were on iron supplementation were excluded.

Results: One hundred patients were included, of which 82 were cured and 18 expired. Of the 18 expired, 12 had rhino-orbito-cerebral mucormycosis (ROCM) and 6 had rhino-orbital mucormycosis. The mean age was 51.12 years and the mean body mass index (BMI) was 25.02 kg/m². The most common comorbidity was diabetes mellitus (85%). The mean duration of antifungals given until the cure of the patient was 30.05 ± 8.34 weeks. Mean hemoglobin and serum iron were low, and serum ferritin was elevated. Facial pain, facial swelling, nasal discharge, decreased vision, and periorbital swelling were the most common presenting symptoms of mucormycosis, and these persisted for a mean duration ranging from 16 to 28 days.

Conclusion: Rhino-orbital mucormycosis was the most common type of mucormycosis. Uncontrolled diabetes mellitus was the most common comorbidity associated with mucormycosis, so it should be treated properly. The mean duration of antifungals given until the cure of the patient was 30.05 ± 8.34 weeks. There was no significant association between the duration of antifungals and glycated hemoglobin (HbA1C), serum ferritin, or type of mucormycosis.