Story of The Black and White Devils- Mucormycosis and Aspergillosis: A Distinct Entity with Rising Clinical Presentation in COVID Era

Background: Background: Fungal rhino-sinusitis is a rare, rapidly progressing, life-threatening opportunistic infection, primarily affecting immunocompromised patients, such as those with diabetes and lung diseases, recently observed in post-COVID pneumonia cases. Clinically, it presents with partial neurological dysfunction and progressive necrosis secondary to blood vessel invasion and thrombosis, potentially involving the cranium, increasing morbidity and mortality. First-line treatment includes antifungal therapy, followed by surgical intervention. Aim: To emphasize the significance of timely diagnosis and treatment strategies for Rhino-orbital-cerebral Mucormycosis and Aspergillosis. Methods: Since the coronavirus outbreak in India, our hospital has treated thousands of patients, including nine confirmed cases of invasive fungal rhino-sinusitis from April to July 2021. We collected data from electronic records to ensure accuracy, with diagnoses based on clinical presentation, nasal endoscopy, imaging, KOH mount, fungal culture, and histopathology. Our team provided tailored medical and surgical management to meet each patient’s needs, demonstrating our commitment to high-quality care during this challenging time. Results: Five out of nine patients survived our treatment; the mortality rate was reported as 37.5%, with one patient lost to follow-up. Conclusion: Timely surgical intervention, effective debridement, and appropriate antifungal therapy can significantly reduce mortality and morbidity in patients with Rhino-orbital-cerebral Mucormycosis and Aspergillosis.