Post COVID Tsunami of Black Fungus – Anaesthetic Challenges in Management: Case Series

Abstract

Rhino-orbital-cerebral Mucor mycosis is a rare, opportunistic, fatal fungal infection most commonly seen in diabetic and immunocompromised individuals, but an outbreak of cases was seen in post COVID-19 patients during the second wave in India. Our aim is to elaborate the anaesthetic management of post COVID-19 Mucor mycosis patients scheduled for FESS (Functional Endoscopic Sinus Surgery) for debridement of involved areas. Here, we have discussed the anaesthetic challenges faced in a series of eleven patients with COVID-19 and Mucor mycosis such as uncontrolled diabetes mellitus, irrational use of steroids for the treatment of COVID-19, amphotericin B and its interactions with anaesthetic management. Preventive measures in COVID-19 patients, early detection, timely management, perioperative vigilant monitoring, multidisciplinary approach will reduce the morbidity and mortality in these patients. As limited data is available, further studies are necessary to understand aetiology and pathogenesis of Mucor mycosis in post COVID-19 for better management.