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mljgoums 2023, 17(3): 1-7 |
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Patel U, Jagrit N, Bhavsar T, Panchal S, Parikh K, Nayak H. Correlation of Diagnostic Yield with Laboratory Parameters and Histopathological Examination in Clinically Suspected Cases of Mucormycosis in Post-COVID-19 Patients: A Single-Center Study in Ahmedabad, India. mljgoums 2023; 17 (3) :1-7
URL: http://mlj.goums.ac.ir/article-1-1549-en.html
URL: http://mlj.goums.ac.ir/article-1-1549-en.html
1- Dept of Biochemistry, AMC MET Medical College, L.G Hospital- Gujrat University, Maninagar, Ahmedabad-380008, Gujarat, India , ushapatel2002@gmail.com
2- Dept of Pathology, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
3- Dept of Microbiology, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
4- ept of Preventive and social medicine, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
2- Dept of Pathology, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
3- Dept of Microbiology, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
4- ept of Preventive and social medicine, AMC MET Medical College, L.G Hospital- Gujarat University, Maninagar, Ahmedabad-380008, Gujarat, India
Abstract: (1303 Views)
Background and objectives: Mucormycosis is a complication in post-coronavirus disease 2019 (COVID-19) patients in India. This study was done to evaluate the prognostic value of clinical, histopathologic findings, microbiological features, and biochemical parameters such as D-dimer, lactate dehydrogenase, and serum ferritin in post- COVID-19-patients with rhino-orbital mucormycosis.
Methods: This retrospective observational study was carried out on biopsies taken from 50 post-COVID-19 patients suspected of mucormycosis. The biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid–schiff, and Wright-Giemsa. In addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect Mucor. The biochemical parameters were measured using ARCHITECT ci8200 chemistry analyzer.
Results: Overall, 30 cases (60%) were positive for fungal elements, and growth of Mucor spp. was found in 28 cases (56%). In histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. There seemed to be a site-wise overlap between the nasal/maxillary sinus and rhino-orbital/rhino-cerebral variety. There was no difference between the patients in terms of gender. The most common risk factor was diabetes mellitus (observed in 80% of cases). In patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, C-reactive protein, and D-dimer were greater than the normal range, whereas procalcitonin was within the reference range.
Conclusion: It can be concluded that raised metabolic markers, direct 10% KOH examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate.
Methods: This retrospective observational study was carried out on biopsies taken from 50 post-COVID-19 patients suspected of mucormycosis. The biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid–schiff, and Wright-Giemsa. In addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect Mucor. The biochemical parameters were measured using ARCHITECT ci8200 chemistry analyzer.
Results: Overall, 30 cases (60%) were positive for fungal elements, and growth of Mucor spp. was found in 28 cases (56%). In histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. There seemed to be a site-wise overlap between the nasal/maxillary sinus and rhino-orbital/rhino-cerebral variety. There was no difference between the patients in terms of gender. The most common risk factor was diabetes mellitus (observed in 80% of cases). In patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, C-reactive protein, and D-dimer were greater than the normal range, whereas procalcitonin was within the reference range.
Conclusion: It can be concluded that raised metabolic markers, direct 10% KOH examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate.
Research Article: Original Paper |
Subject:
Mycology
Received: 2022/07/12 | Accepted: 2023/01/25 | Published: 2023/05/21 | ePublished: 2023/05/21
Received: 2022/07/12 | Accepted: 2023/01/25 | Published: 2023/05/21 | ePublished: 2023/05/21
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