The prior era from 2021 to 2022 saw an increase in the spread of mucormycosis, and this explanation is probably related to the introduction of illnesses that lower immunity, including the Corona virus, which peaked between 2020 and 2022. Due to a shift in their innate immunity as well as a poor adaptive immune system, diabetes patients also developed mucous fungus. Numerous studies have examined the link between diabetes and the prevalence of mucosal fungus, but none have clearly proven the cause of this association.[6, 7].
Our study comprised 59 mucormycosis patients, the majority of whom had uncontrolled diabetes (95%). Our findings were consistent with those of other studies conducted internationally; an Indian study found that 75% of mucormycosis patients had uncontrolled diabetes [8].
One-third of the mucormycosis patients in a French study who were diagnosed with diabetes had the disease [9].
According to a global study, 42% of the 41 patients who had mucormycosis also had diabetes or one of its complications, such as diabetic ketoacidosis, making up 83% of the patients [10].
Due to the impact of uncontrolled diabetes on immunity and the sporadic use of corticosteroids during the COVID-19 outbreak, infection with diabetes and Covid-19 increased the susceptibility to infection with mucormycosis, and the findings of our study were consistent with those of other studies conducted internationally [11]. Patients who are not immunocompromised rarely get mucormycosis. The main risk factor in these situations is skin barrier penetration, such as during surgery.
Patients with mucormycosis may experience a variety of symptoms, including nasal blockage, congestion, headaches, and damage to the cranial nerves. The nerves 2-3-4-5-6-7 were the most frequently injured, which caused eye paralysis and drooping eyelids.
These findings concur with those of worldwide research, which showed that the maxillary and orbital symptoms of osteomyelitis are those that occur most frequently in patients with this condition [12, 13].
According to additional research, people with uncontrolled diabetes experience faster unilateral and bilateral vision loss worsening [14].
On computed tomography, densities in the sinuses, which are the outcome of a mucous fungal infection, can be seen. Both homogeneous and heterogeneous densities are possible. According to our findings, these densities were homogeneous in 42% and heterogeneous in 31% of the cases.
These radiographic findings are in line with the results of studies conducted internationally, which show that CT exhibits thickening and densities within the mucous membrane of the sinuses along with the destruction of nearby bones, while MRI assesses the extent of these densities and lesions to the cavernous sinus and assesses the extent of these lesions extending to the brain tissue [15].
A sample collected from the obvious lesion in the nasal cavity confirmed the diagnosis of mycosis fungoides. This biopsy revealed positive results for mucormycosis in 39 cases (66%).
International studies demonstrate the necessity of taking tissue samples from the affected area, whether it be by scraping the nasal mucosa or taking tissue samples [16].
Endoscopic functional sinus surgery, which is the cornerstone of the therapy of this disease, was administered to several patients. In addition to receiving antibiotics to address infections brought on by this condition, they also received systemic antifungals like amphotericin and fluconazole.
While worldwide research suggests that this surgery should be completed quickly when identifying an injury, particularly in the event of sinusitis, to minimize cranial and orbital invasion, this sort of procedure may also have aesthetic and functional side effects [17].