Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Research Article Volume 4 Issue 2

Multiple and Appropriate Sampling Proved as Key for Early Diagnosis of COVID Associated Mucormycosis

Archana Keche1, Nitin M Nagarkar2, Swati Salila3*, Ripu Daman Arora4, Rupa Mehta4 and Richa Tigga3

1Additional Professor, Department of Microbiology, AIIMS, Raipur, India
2Professor and Head, Department of Otorhinolaryngology, Director and CEO, AIIMS, Raipur, India
3Senior Resident, Department of Microbiology, AIIMS, Raipur, India
4Additional Professor, Department of Otorhinolaryngology, AIIMS, Raipur, India

*Corresponding Author: Swati Salila, Senior Resident, Department of Microbiology, AIIMS, Raipur, India.

Received: November 02, 2021; Published: January 20, 2022


Mucormycosis is a life-threatening, opportunistic infection, caused by a group of saprophytic fungi belonging to taxonomical Order Mucorales. Severe COVID-19 disease is associated with an increase in pro-inflammatory markers, this, increases the susceptibility to various infections. One such opportunistic fungal infection involved is mucormycosis, an angio-invasive disease which is often linked to the use of high dose steroid therapy for longer duration. In this study samples were taken from post COVID-19 patients suspected of mucormycosis, requested for direct KOH microscopy and fungal culture. A total of 699 samples were processed (including repeat samples) received from 361 post COVID-19 patients. Out of the 361 patients screened by KOH/Calcoflour white preparation, 101(27.9%) came to be positive after first time sampling. On repeat sampling, 36 patients (9.97%%) were additionally picked as positive. A total of 137 patients were positive on screening by KOH. Hence, the positivity rate was increased from 27.9% to 37.87% on multiple and appropriate sampling. Diagnosis of Mucormycosis remains a challenging task. Multiple sampling of the accessible site of infected area can be a key to early diagnosis of CAM in emergency. The mortality as well as morbidity can be reduced by prompt diagnosis and treatment initiation.

Keywords: COVID Associated Mucormycosis (CAM); Multiple Sampling; Early Diagnosis


  1. Ibrahim AS., et al. “Pathogenesis of Mucormycosis”. Clinical Infectious Diseases 54 (2012): S16-22.
  2. Prakash H and Chakrabarti A. “Epidemiology of Mucormycosis in India”. Microorganisms3 (2021).
  3. Mekonnen ZK., et al. “Acute Invasive Rhino-Orbital Mucormycosis in a Patient With COVID-19-Associated Acute Respiratory Distress Syndrome”. Ophthalmic Plastic and Reconstructive Surgery 2 (2021): e40-80.
  4. Bhatt K., et al. “High mortality co-infections of COVID-19 patients: mucormycosis and other fungal infections”. Discoveries 1 (2021).
  5. Chander J., et al. “Mucormycosis: Battle with the Deadly Enemy over a Five-Year Period in India”. Journal of Fungi2 (2018).
  6. Gumral R., et al. “A Case of Rhinoorbital Mucormycosis in a Leukemic Patient with a Literature Review from Turkey”. Mycopathologia5 (2011): 397.
  7. Chander J. “Textbook of Medical Mycology”. JP Medical Ltd (2017): 958.
  8. Patel A., et al. “Multicenter Epidemiologic Study of Coronavirus Disease-Associated Mucormycosis, India”. Emerging Infectious Diseases Journal – CDC 27.9 (2021): 2349-2359..
  9. Jeong W., et al. “The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports”. Clinical Microbiology and Infection 1 (2019): 26-34.
  10. Accili D. “Can COVID-19 cause diabetes?” Nature Metabolism2 (2021): 123-125.
  11. Müller JA., et al. “SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas”. Nature Metabolism2 (2021): 149-165.
  12. Roden MM., et al. “Epidemiology and Outcome of Zygomycosis: A Review of 929 Reported Cases”. Clinical Infectious Diseases5 (2005): 634-653.
  13. Lanternier F., et al. “A global analysis of mucormycosis in France: the RetroZygo Study (2005-2007)”. Clinical Infectious Diseases 54 (2012): S35-43.
  14. Garg D., et al. “Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature”. Mycopathologia (2021): 1-10.
  15. Kindo A., et al. “Fatal cellulitis caused by apophysomyces elegans”. Indian Journal of Medical Microbiology 3 (2007): 285-287.
  16. Woo PC., et al. “A significant number of reported Absidia corymbifera (Lichtheimia corymbifera) infections are caused by Lichtheimia ramosa (syn. Lichtheimia hongkongensis): an emerging cause of mucormycosis”. Emerging Microbes and Infections 8 (2012): e15.
  17. “Aero mycological analysis of Mucormycetes in indoor and outdoor environments of northern India”. Medical Mycology | Oxford Academic 58.1 (2021): 118-123.


Citation: Swati Salila., et al. “Multiple and Appropriate Sampling Proved as Key for Early Diagnosis of COVID Associated Mucormycosis".Acta Scientific Otolaryngology 4.2 (2022): 02-07.


Copyright: © 2022 Swati Salila., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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