{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:19:54Z","timestamp":1787761194395,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Mucormycosis once considered a rare disease with an incidence of 0.005 to 1.7 per million, has become one of the greatest menaces during the coronavirus disease (COVID-19) pandemic. India alone has contributed to nearly 70% of the global caseload of COVID-associated mucormycosis (CAM) and it had even been declared as a notifiable disease. Second wave of COVID-19 pandemic saw a steep rise in the incidence of mucormycosis and these patients have been presenting to anesthesiologists for various surgical procedures due to its primary or secondary sequelae. Rhino-orbito-cerebral mucormycosis (ROCM) is the commonest manifestation and is caused by Rhizopus arrhizus. Injudicious use of corticosteroids in vulnerable patients could have been a major contributing factor to the sudden rise in ROCM during the pandemic. Concerns related to anesthetic management include COVID-19 infection and post COVID sequalae, common presence of uncontrolled diabetes mellitus, possibility of difficult mask-ventilation and\/or intubation, various drug therapy-associated adverse effects, and interaction of these drugs with anesthetic agents. Thorough preoperative optimization, multidisciplinary involvement, perioperative care, and vigilance go a long way in improving overall outcomes in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_640_22","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T08:16:27Z","timestamp":1671696987000},"page":"58-64","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["COVID-19 associated Mucormycosis (CAM)"],"prefix":"10.4103","volume":"17","author":[{"given":"Anju","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Kayarat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishkarsh","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-9-20240909","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.cmi.2018.07.011","article-title":"The epidemiology and clinical manifestations of mucormycosis: A systematic review and meta-analysis of case reports","volume":"25","author":"Jeong","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"R2-9-20240909","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/S2213-2600(21)00265-4","article-title":"Rising incidence of mucormycosis in patients with COVID-19: Another challenge for India amidst the second wave?","volume":"9","author":"Raut","year":"2021","journal-title":"Lancet Respir Med"},{"key":"R3-9-20240909","doi-asserted-by":"crossref","first-page":"985","DOI":"10.3390\/jof7110985","article-title":"Global prevalence of COVID-19-associated mucormycosis (CAM): Living systematic review and meta-analysis","volume":"7","author":"Hussain","year":"2021","journal-title":"J Fungi (Basel"},{"key":"R4-9-20240909","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1093\/cid\/cir864","article-title":"Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: Molecular mycologic perspectives","volume":"54","author":"Kwon-Chung","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R5-9-20240909","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/j.tripleo.2011.04.048","article-title":"Management and outcomes of three cases of rhinocerebral mucormycosis","volume":"112","author":"Viterbo","year":"2011","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R7-9-20240909","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s11046-021-00584-8","article-title":"Epidemiology and pathophysiology of COVID-19-associated mucormycosis: India versus the rest of the world","volume":"186","author":"Muthu","year":"2021","journal-title":"Mycopathologia"},{"key":"R8-9-20240909","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1093\/mmy\/myz031","article-title":"An aero mycological analysis of Mucormycetes in indoor and outdoor environments of northern India","volume":"58","author":"Prakash","year":"2020","journal-title":"Med Mycol"},{"key":"R9-9-20240909","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s40475-020-00222-1","article-title":"Host-pathogen molecular factors contribute to the pathogenesis of rhizopus spp. in diabetes mellitus","volume":"8","author":"Morales-Franco","year":"2021","journal-title":"Curr Trop Med Rep"},{"key":"R10-9-20240909","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1172\/JCI42164","article-title":"The endothelial cell receptor GRP78 is required for mucormycosis pathogenesis in diabetic mice","volume":"120","author":"Liu","year":"2010","journal-title":"J Clin Invest"},{"key":"R11-9-20240909","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1093\/cid\/cir865","article-title":"Pathogenesis of mucormycosis","volume":"54","author":"Ibrahim","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R12-9-20240909","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S1474-4422(21)00415-4","article-title":"Neurological infections in 2021: A spotlight on India","volume":"21","author":"Garg","year":"2022","journal-title":"Lancet Neurol"},{"key":"R13-9-20240909","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJMoa2021436","article-title":"Dexamethasone in Hospitalized Patients with Covid-19","volume":"384","author":"Horby","year":"2021","journal-title":"N Engl J Med"},{"key":"R14-9-20240909","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.4103\/ijo.IJO_1565_21","article-title":"Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India - 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