{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:11:50Z","timestamp":1761664310007},"reference-count":17,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The gravity of \u201csecond wave\u201d of COVID-19 has effaced many new challenges in India; mucormycosis being a recent one. Diabetes mellitus (DM) is a known significant risk factor for mucormycosis. Here, we present our experience with rhino-orbital-cerebral mucormycosis (ROCM) during the \u201csecond wave of COVID-19\u201d at a tertiary health care centre in North India.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>This case series includes four cases of ROCM that were managed by our neurosurgical team in view ofcerebral involvement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>All the cases with an exception of one (Case 1), had a history of treatment for COVID-19 pneumonia. Case 2, 3 had undergone functional endoscopic sinus surgery (FESS) and orbital decompression before the onset of cerebral involvement; Case 4 underwent FESS and cranial surgery in the same sitting. All the patients had a history of DM and all the cases treated for COVID-19 pneumonia had a history of treatment with corticosteroids. Two patients underwent surgery with the exception of one patient, who did not provide consent for the same. One patient expired before surgical excision could be attempted.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Regular and intensive follow-up is the key in swift detection and management of ROCM in post-COVID patients. While surgical excision is advisable in the fungal lesion, it must be borne in mind that radical excision of cerebral lesions is associated with morbidity, delayed recovery, and prolonged ICU stay. Culture and sensitivity-based antibiotics should be used judiciously as fever is a common postoperative complication. Blood sugar monitoring and control of DM are paramount in this condition. Steroids should be avoided in the management of cerebral edema with judicious use of hypertonic saline or mannitol.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_772_2021","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T12:04:51Z","timestamp":1635163491000},"page":"538","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rhino-orbital-cerebral mucormycosis in times of COVID-19: A neurosurgical experience"],"prefix":"10.25259","volume":"12","author":[{"given":"Hershdeep","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Dua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amitabh","family":"Goel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Dhar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Bhadauria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Garg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikrant","family":"Katyar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumit","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditi","family":"Shukla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"10.25259\/SNI_772_2021\/ref-1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jinf.2009.06.002","article-title":"A clinicopathological study of pulmonary mucormycosis in cancer patients: Extensive angioinvasion but limited inflammatory response","volume":"59","author":"Ben-Ami","year":"2009","journal-title":"J Infect"},{"key":"10.25259\/SNI_772_2021\/ref-2","article-title":"Estimating Fungal Infection Burden in India: Mucormycosis Burden as a Case Study","author":"Chakrabarti","year":"2021"},{"key":"10.25259\/SNI_772_2021\/ref-3","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/00007890-200202150-00026","article-title":"Successful treatment of Mucor infection after liver or pancreas-kidney transplantation","volume":"73","author":"Jimenez","year":"2002","journal-title":"Transplantation"},{"key":"10.25259\/SNI_772_2021\/ref-4","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/0-306-46844-1_5","article-title":"Fungal infections","volume-title":"MR Imaging and Spectroscopy of Central Nervous System Infections","author":"Kathuria","year":"2001"},{"key":"10.25259\/SNI_772_2021\/ref-5","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1086\/313803","article-title":"Zygomycosis in the 1990s in a tertiary-care cancer center","volume":"30","author":"Kontoyiannis","year":"2000","journal-title":"Clin Infect Dis"},{"key":"10.25259\/SNI_772_2021\/ref-6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1469-0691.2009.02974.x","article-title":"Clinical presentation of zygomycosis","volume":"15","author":"Mantadakis","year":"2009","journal-title":"Clin Microbiol Infect"},{"key":"10.25259\/SNI_772_2021\/ref-7","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1046\/j.1440-1673.2000.00751.x","article-title":"Craniofacial mucormycosis following assault: An unusual presentation of an unusual disease","volume":"44","author":"Melsom","year":"2000","journal-title":"Australas Radiol"},{"key":"10.25259\/SNI_772_2021\/ref-8","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1086\/595846","article-title":"Epidemiology and outcome of invasive fungal infection in adult hematopoietic stem cell transplant recipients: Analysis of multicenter prospective antifungal therapy (PATH) alliance registry","volume":"48","author":"Neofytos","year":"2009","journal-title":"Clin Infect Dis"},{"key":"10.25259\/SNI_772_2021\/ref-9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/jof5010026","article-title":"Global epidemiology of mucormycosis","volume":"5","author":"Prakash","year":"2019","journal-title":"J Fungi (Basel)"},{"key":"10.25259\/SNI_772_2021\/ref-10","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1086\/432579","article-title":"Epidemiology and outcome of zygomycosis: A review of 929 reported cases","volume":"41","author":"Roden","year":"2005","journal-title":"Clin Infect Dis"},{"key":"10.25259\/SNI_772_2021\/ref-11","first-page":"932","article-title":"Indolent intracranial mucormycosis: Case report","volume":"23","author":"Rumboldt","year":"2002","journal-title":"J Neuroradiol"},{"key":"10.25259\/SNI_772_2021\/ref-12","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S0730-725X(00)00180-6","article-title":"Cerebral mucormycosis: Proton MR spectroscopy and MR imaging","volume":"18","author":"Siegal","year":"2000","journal-title":"Magn Reson Imaging"},{"key":"10.25259\/SNI_772_2021\/ref-13","doi-asserted-by":"crossref","first-page":"102146","DOI":"10.1016\/j.dsx.2021.05.019","article-title":"Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India","volume":"15","author":"Singh","year":"2021","journal-title":"Diabetes Metab Syndr"},{"key":"10.25259\/SNI_772_2021\/ref-14","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-200811","article-title":"Rhinocerebral mucormycosis in a patient with Type 1 diabetes presenting as toothache: A case report from Himalayan region of India","author":"Singh","year":"2013","journal-title":"BMJ Case Rep"},{"key":"10.25259\/SNI_772_2021\/ref-15","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1128\/CMR.18.3.556-569.2005","article-title":"Novel per-spectives on mucormycosis: Pathophysiology presentation, and management","volume":"18","author":"Spellberg","year":"2005","journal-title":"Clin Microbiol Rev"},{"key":"10.25259\/SNI_772_2021\/ref-16","article-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases","author":"Sugar","year":"2000","edition":"5th ed"},{"key":"10.25259\/SNI_772_2021\/ref-17","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1002\/lary.23912","article-title":"Survival outcomes in acute invasive fungal sinusitis: A systematic review and quantitative synthesis of published evidence","volume":"123","author":"Turner","year":"2013","journal-title":"Laryngoscope"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/rhino-orbital-cerebral-mucormycosis-in-times-of-covid-19-a-neurosurgical-experience\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/rhino-orbital-cerebral-mucormycosis-in-times-of-covid-19-a-neurosurgical-experience\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T12:05:02Z","timestamp":1635163502000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/rhino-orbital-cerebral-mucormycosis-in-times-of-covid-19-a-neurosurgical-experience\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":17,"alternative-id":["10.25259\/SNI_772_2021"],"URL":"https:\/\/doi.org\/10.25259\/sni_772_2021","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"article-number":"538"}}