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1.
Journal of the Pakistan Medical Association ; 72(6):1225-1228, 2022.
Article in English | EMBASE | ID: covidwho-1885006

ABSTRACT

For almost one and a half year the world is facing the pandemic called COVID-19, which is an acute respiratory distress syndrome caused by coronavirus 2 (SARS-CoV2). This disease has already engulfed many lives and has not been tamed so far. Physicians all over the world still, trying to get a hold of this global health issue, are faced with another life-threatening challenge associated with COVID-19, called black fungus-Mucormycosis. Within a span of few weeks, we have encountered three cases of black fungus in our institute which has stirred a serious concern among physicians in Pakistan.

2.
J Microbiol Immunol Infect ; 55(2): 183-190, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1882247

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly become a global threaten since its emergence in the end of 2019. Moreover, SARS-CoV-2 infection could also present with co-infection or secondary infection by other virus, bacteria, or fungi. Among them, mucormycosis is a rare but aggressive fungal disease and it mainly affects patients particularly with poorly controlled diabetes mellitus with diabetic ketoacidosis (DKA). We here did a comprehensive review of literature reporting COVID-19 associated with mucormycosis (CAM) cases, which have been reported worldwide. The prevalence is higher in India, Iran, and Egypt than other countries, particularly highest in the states of Gujarat and Maharashtra in India. Poor diabetic control and the administration of systemic corticosteroids are the common precipitating factors causing mucormycosis in the severe and critical COVID-19 patients. In addition, COVID-19 itself may affect the immune system resulting in vulnerability of the patients to mucormycosis. Appropriate treatments of CAM include strict glycemic control, extensive surgical debridement, and antifungal therapy with amphotericin B formulations.


Subject(s)
COVID-19 , Coinfection , Diabetic Ketoacidosis , Mucormycosis , Antifungal Agents/therapeutic use , COVID-19/complications , Coinfection/drug therapy , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/epidemiology , Humans , India/epidemiology , Mucormycosis/drug therapy , Mucormycosis/epidemiology , SARS-CoV-2
3.
Ann Med Surg (Lond) ; 78: 103911, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1881656

ABSTRACT

Introduction: and importance: There are increasing case reports of mucormycosis in patient with coronavirus disease 2019 (Covid-19). Herein, we describe the case of mucormycosis after recovery from Covid-19. Case presentation: The patient was a 73 years old woman with a history of chronic kidney disease, diabetes mellitus, hypertension, and dyslipidemia that referred to the emergency department with clinical presentation of Covid-19. On the third day of admission, the Covid-19 PCR test was negative, but the patient presented headache and pain in her upper jaw. Physical examination showed fever, erythema, and tenderness in the right cheek. Emergency biopsy and culture from sinus by subsection to mucormycosis conducted. and the diagnosis of mucormycosis was confirmed by the positive result of biopsy and culture. Despite anti-fungal treatment with Amphotericin B, patient developed severe diarrhea and became hemodynamically unstable. In the stool analysis, Strongyloides stercoralis was reported. Unfortunately, patient was expired on day thirty-two of this admission. Clinical discussion: Mucormycosis is a dangerous infection, and its rapid diagnosis is so important. On the other hand, Covid-19 may associated with many nonspecific sign and symptoms. These finding may overlap with other infections.In patients with prolonged mucormycosis infection, the development of strongyloidiasis should not be neglected. A single dose of ivermectin as strongyloidiasis prophylaxis should be given if the duration of the illness is prolonged. Conclusion: Clinicians should consider mucormycosis and its complications after Covid-19 treatment in diabetic and immunocompromised patients.

4.
An Bras Dermatol ; 2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1881588

ABSTRACT

COVID-19 disease caused by the SARS-CoV-2 coronavirus causes a wide range of clinical manifestations, ranging from mild to severe, with the main ones affecting the respiratory tract, such as pneumonia. In patients with greater severity, the high frequency of bacterial and fungal coinfection stands out, a situation related both to the patient's pre-existing comorbidities and due to the hospitalization itself. Cases of mucormycosis associated with COVID-19 were highlighted in the lay and scientific media, with the increase in mycosis cases being directly and indirectly attributed to the viral infection. This report describes a case of rhino-orbito-cerebral mucormycosis in a diabetic patient hospitalized for COVID-19, whose diagnosis was confirmed by identifying the agent Rhizopus microsporus var. microsporus through culture for fungi and PCR examination.

5.
AACN Adv Crit Care ; 33(2): 165-172, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1879534

ABSTRACT

Critically ill patients are at high risk for organ failure, including that of the integumentary system. Nurses working in intensive care are adept at performing comprehensive assessments that include the skin. Although pressure injury is a well-known complication associated with critical illness, patients may also have debilitating and life-threatening dermatoses. Conditions such as skin failure and medical adhesive-related skin damage are commonly seen in the critically ill. Infectious processes, such as Fournier gangrene, invasive candidiasis, mucormycosis, and herpetic lesions, can result in severe or superimposed critical illness and elude detection. Similarly, cutaneous manifestations of COVID-19 may develop prior to commonly recognized symptoms of infection. Nurses and providers caring for critically ill patients should be aware of common, but less widely known, skin conditions to facilitate early detection and treatment.


Subject(s)
COVID-19 , Candidiasis , Critical Care , Critical Illness , Humans , Intensive Care Units
6.
Future Microbiol ; 17: 755-762, 2022 07.
Article in English | MEDLINE | ID: covidwho-1879384

ABSTRACT

During the past few months, mucormycosis has been associated with SARS-CoV-2 infections. Molecular docking combined with molecular dynamics simulation is utilized to test nucleotide-based inhibitors against the RdRps of SARS-CoV-2 solved structure and Rhizopus oryzae RdRp model built in silico. The results reveal a comparable binding affinity of sofosbuvir, galidesivir, ribavirin and remdesivir compared with the physiological nucleotide triphosphates against R. oryzae RdRp as well as the SARS-CoV-2 RdRp as reported before. Additionally, other compounds such as setrobuvir, YAK, IDX-184 and modified GTP compounds 2, 3 and 4 show potential calculated average binding affinities against R. oryzae RdRp. The present in silico study suggests the dual inhibition potential of the recommended drugs and compounds against SARS-CoV-2 and R. oryzae RdRps.


Subject(s)
COVID-19 , Mucormycosis , Antiviral Agents/chemistry , COVID-19/drug therapy , Fungi , Humans , Molecular Docking Simulation , Mucormycosis/drug therapy , RNA-Dependent RNA Polymerase , SARS-CoV-2
7.
Int J Surg Pathol ; : 10668969221099626, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879206

ABSTRACT

Introduction. COVID-19 is an infection caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is an opportunistic fungal infection occurring in post COVID-19 patients. Objectives. To study the role of histopathology in mucormycosis and the predisposing factors associated in development of mucormycosis in post COVID-19 patients. Materials and methods. A prospective observational study was conducted in our hospital in the pathology department over a period of 3 months on 200 patients with mucormycosis who were infected with SARS-CoV-2 virus. Results. Out of the 200 patients with mucormycosis studied in post COVID-19 patients, age ranged from 21-80 years, of which 132 were men and 68 were women. Sites involved by mucormycosis were sinuses, orbit, cranium, and cutaneous. Ethmoid sinus was most involved, followed by maxillary sinus. Diabetes was present in 162 patients and hypertension in 92 patients. On histopathological examination, fungal load was severe in 49 patients, angioinvasion was present in 48 patients, perineural invasion was present in 32 patients, and necrosis was present in 121 patients. The number of patients discharged after surgery was 169, whereas 31 died. Conclusion. Histopathological features of mucormycosis like angioinvasion, perineural invasion, severe fungal load, and large areas of necrosis were directly proportional to the mortality rate. Thus, histopathologists can help in assessing prognosis at the time of tissue diagnosis, so that clinicians can optimize treatment accordingly. Diabetes and history of corticosteroid intake for treatment of COVID-19 were the two commonest predisposing factors for development of mucormycosis.

8.
Journal of Pharmacy and Bioallied Sciences ; 14(1):46-51, 2022.
Article in English | ProQuest Central | ID: covidwho-1875948

ABSTRACT

Background: There was a global surge in cases of mucormycosis in COVID-19 patients during the second wave of the pandemic in 2021, reported especially from India. Various predisposing factors such as diabetes mellitus, rampant use of corticosteroids, and COVID-19 per se may be responsible for this spike. Some public health experts have postulated that the epidemiological link between the Delta variant of SARS-CoV-2 and mucormycosis should be explored. Material and Methods: A retrospective exploratory study was conducted, in which data of 15 laboratory-confirmed cases of COVID-19 with mucormycosis and/or aspergillosis co-infections were collected after obtaining approval from the institute's ethics committee. These patients were admitted to the Mucor wards of our hospital. The positive COVID-19 status of these patients was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). The residual SARS-CoV-2 RNA containing elutes of these patients were stored at −80°C in deep freezers and subjected to whole-genome sequencing in June 2021 at the National Centre for Disease Control (NCDC), New Delhi, India as part of the Indian SARS-CoV-2 Genomic Consortia (INSACOG) program. Concomitant fungal infections in these patients were diagnosed by KOH wet mount and fungal culture as per standard guidelines. Descriptive statistics in the form of percentages and median were used to report the findings. Results: Periorbital swelling and ocular pain (14/15;93.33%), followed by facial swelling (11/15;73.33%) and nasal obstruction (9/15;60%), were the most common clinical features observed in these patients. Rhizopus arrhizus was the most common causative fungal agent (12/15;80%). The majority of the patients (9/13;69.23%) were infected with the Delta variant of SARS-CoV-2. Conclusion: COVID-associated mucormycosis seems to be multifactorial in origin. Although there may be a possible association between mucormycosis and the Delta variant, more studies should be conducted to explore this seemingly reasonable proposition.

9.
Journal of Family Medicine and Primary Care ; 11(5):1672-1676, 2022.
Article in English | CAB Abstracts | ID: covidwho-1875931

ABSTRACT

Individuals who have shown recovery from coronavirus disease (COVID-19) are increasingly getting diagnosed with Mucormycosis or "Black fungus." It is a difficult condition to diagnose as it has symptoms that are common among a variety of diseases. Hence, it is important to identify the presenting signs and understand the underlying pathogenesis of COVID-19 associated Mucormycosis. The incidence of these mycotic infections has shown a substantial increase in current times owing to an increase in the prevalence of immunocompromised subjects, human immunodeficiency virus (HIV) infection, and acquired immunodeficiency syndrome (AIDS). Any suspected case of mucormycosis requires rapid diagnosis and management due to its rapid progression as well as the destructive course of infection. This article reviews the taxonomy, pathogenesis, and clinical signs along with laboratory investigations that may play a vital role in the timely diagnosis of this condition as it is mostly fatal.

10.
Journal of Family Medicine and Primary Care ; 11(5):1664-1671, 2022.
Article in English | CAB Abstracts | ID: covidwho-1875930

ABSTRACT

Upsurge in mucormycosis cases in the second wave of SARS CoV2 infection in India has been reported. Uncontrolled diabetes is the major predisposing risk factor for these cases. The early diagnosis and surgical intervention with medical treatment may result in good clinical outcomes. The glycaemic control in diabetic patients also favours better treatment outcome in patients suffering from mucormycosis.

11.
Indian J Ophthalmol ; 70(6): 2163-2168, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1875907

ABSTRACT

Purpose: An unprecedented surge has been noted in rhino-orbital-Cerebral mucormycosis (ROCM) in times of current COVID-19 pandemic. The present prospective study aims to evaluate clinico-epidemiological profile, risk factors, management, and outcome of the cases of ROCM that presented to our tertiary care center during the study period from April to June 2021. Methods: All patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were staged and were treated with intravenous liposomal amphotericin B (AMB) and sino-nasal debridement of local necrotic tissue. Transcutaneous retrobulbar AMB (TRAMB), orbital decompression, and exenteration were instituted as indicated. All patients were followed up for a minimum of 6 months before arriving at the final outcome. Statistical analysis was performed. Results: A total of 49 patients presented during the study period, with a mean age of 42.2 years. The major risk factors included uncontrolled diabetes (89.8%), COVID-19 positivity (51.02%), and concurrent steroid use (38.77%). The most common presenting symptom was facial pain/swelling (43.65%), while the most common presenting sign was deterioration in vision (75.51%). Intravenous liposomal AMB was given to all patients along with sino-nasal debridement (85.71%), TRAMB (57.14%), orbital decompression (14.28%), and exenteration (12.24%). Overall, mortality at 6 months was 22.45% (11 patients). Age more than 60 years, intracranial extension, and HbA1c of more than 8.0% were observed to be statistically significant indicators of mortality. Conclusion: Early suspicion and timely diagnosis of mucormycosis at rhino-orbital stage is warranted in order to salvage life as well as visual function. TRAMB may prove as potentially favorable treatment modality in cases with limited orbital involvement.


Subject(s)
COVID-19 , Eye Diseases , Mucormycosis , Orbital Diseases , Adult , Antifungal Agents/therapeutic use , COVID-19/complications , COVID-19/epidemiology , Eye Diseases/complications , Humans , India/epidemiology , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Orbital Diseases/diagnosis , Orbital Diseases/epidemiology , Orbital Diseases/therapy , Pandemics , Prospective Studies , Tertiary Care Centers
12.
Indian J Ophthalmol ; 70(6): 2158-2162, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1875904

ABSTRACT

Purpose: To study the awareness on mucormycosis among outpatients who visited six tertiary eye care hospitals at Madurai, Pondicherry, Coimbatore, Tirunelveli, Chennai, and Tirupati. Methods: This was a telephone-based survey conducted using questionnaires consisting of 38 questions in five sections from July 5 to 25, 2021. Patients visiting the eye hospitals for an examination were contacted over their phones and responses were directly entered onto the Google forms platform. Results: A total of 4573 participants were included in the study. Among all participants, a cumulative 83% of participants had some knowledge of mucormycosis. More than 80% of them reported that their prime source of information was through mass communication like television or radio. Around 34.8% of the respondents were aware that it can occur after treatment for coronavirus disease 2019 (COVID-19) infection, only half of them (54.3%) knew that systemic steroids were the main risk factor. The knowledge scores were higher for participants who were diabetics (n = 1235) or had been affected by COVID-19 earlier (n = 456) or whose friends had mucormycosis earlier (n = 312). Knowledge, attitude, and practice (KAP) scores of nonprofessional health-care workers (n = 103) were much better compared to patients. Conclusion: Such KAP studies give us an idea of the impact of the measures taken for educating the public. In this study, a cumulative 83% of participants had some knowledge of mucormycosis and 86% knew that this was an emergency. More than 50% of the participants were not aware that diabetes is a risk factor for mucormycosis.


Subject(s)
COVID-19 , Diabetes Mellitus , Mucormycosis , COVID-19/epidemiology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Hospitals , Humans , India/epidemiology , Mucormycosis/diagnosis , Mucormycosis/epidemiology , Mucormycosis/therapy , Surveys and Questionnaires
13.
Int J Infect Dis ; 121: 203-210, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1873078

ABSTRACT

BACKGROUND: A surge in COVID-19-associated mucormycosis cases has been observed during the second wave of COVID-19 in summer of 2021. Most cases were reported from India. The Delta variant (B.1.617.2) was the most common variant circulating at that time. Mucormycosis is an opportunistic angioinvasive fungal infection with high morbidity and mortality. METHODS: We present 10 cases of COVID-19-associated rhino-orbital and rhino-orbital-cerebral mucormycosis managed in a secondary hospital in Oman. RESULTS: The median time for developing mucormycosis was two weeks after COVID-19 diagnosis. All patients were newly diagnosed or already known to have poorly controlled diabetes mellitus. Five patients received corticosteroid therapy for COVID-19. Three patients had severe COVID-19 and died of severe acute respiratory distress syndrome and septic shock. Another three patients died of advanced mucormycosis and cerebral involvement. Despite aggressive medical and surgical intervention, the mortality rate was 60% (6/10). CONCLUSION: Mucormycosis is an aggressive opportunistic infection with high morbidity and mortality that requires prompt recognition and urgent intervention. Uncontrolled blood sugar, the use of corticosteroids, and immune dysfunction due to COVID-19 are all important risk factors for development of mucormycosis. Worse outcomes are associated with poor glycemic control despite aggressive medical and surgical interventions.


Subject(s)
COVID-19 , Mucormycosis , Opportunistic Infections , COVID-19/complications , COVID-19 Testing , Humans , Mucormycosis/complications , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Opportunistic Infections/complications , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , SARS-CoV-2
14.
Library Hi Tech ; 2022.
Article in English | Scopus | ID: covidwho-1874123

ABSTRACT

Purpose: Mucormycosis has evolved as a post-COVID-19 complication globally, especially in India. The research on fungus has been very primitive, and many scientific publications have been discovered. The current COVID-19 pandemic needs further investigation into this unusual fungal infection. This review study aims to provide a pen-picture to researchers, science policymakers and scientists about different bibliometric indicators related to the research literature on mucormycosis. Design/methodology/approach: The quantitative research was conducted using the established procedure of bibliometric investigation on data collected from Scopus from 2011 to 2020 using a validated search query. The search query consisted of keywords “Mucormycosis” or “Mucormycoses” or “Mucormycose” or “Mucorales Infection” or “Mucorales Infections” or “Black Fungus Infection” or “Black Fungus Infections” or “Zygomycosis” in the “Title-Keyword-” search option for data extraction. The analysis of data is performed using MS-Excel. Mapping was done with state-of-the-art visualization tools Biblioshiny and VOSviewer, using bibliometric indicators as units of analysis. Findings: The analysis reveals that the first publication on this topic was reported from 1923 onwards. In total, 9,423 authors contributed 1,896 papers with 11,437 collaborated authors, documents per author are 0.201, authors per document are 4.97 and co-authors per document are 6.03. Total records were published in 779 journals in the English language from 75 countries globally. Mucormycosis literature is mostly open access, with 1,210 publications available via different open access routes. The highest number of articles (204) published in the journal “Mycoses” with 1,333 authors received 4,875 cited references, and the h-index has 24. The growth of publications is exponential, as depicted by the Price Law. The USA has recorded a maximum number of publications at both country and institutional levels compared to the other nations. There has been extensive research on mucormycosis before the outbreak as a post-COVID complication, as indicated by the highest number of publications in 2019. Practical implications: The research hot spots have altered from “Mucormycosis,” “fungi,” “Zygomycosis” and “Drug efficacy”, “Drug Safety” to “Microbiology,” “Pathology,” “nucleotide sequence,” “surgical debridement” which indicates that potential area of research in the near future will be concerned with more extensive research in mucormycosis to develop standard treatment procedures to fight this infection. The quantity of scientific publications has also increased over time. The research and health community are called upon to join forces to activate existing knowledge, generate new insights and develop decision-supporting tools for health authorities in different nations to leverage vaccination in its transformational role toward successfully attaining nil cases of COVID-19. Originality/value: The analysis of collaboration, findings, the research networks and visualization makes this study novel and separates from traditional metrics analysis. To the best of the authors’ knowledge, this work is original, and no similar studies have been found with the objectives included here. © 2022, Emerald Publishing Limited.

15.
HVM Bioflux ; 14(1):47-53, 2022.
Article in English | CAB Abstracts | ID: covidwho-1870793

ABSTRACT

The burden of COVID-19 is not only represented by pneumonia and acute respiratory failure, but also by its numerous complications, especially those unexpected or less reported. In view of this, we present the case of a 71 years old male patient admitted for severe acute respiratory failure and sudden alteration of the general condition who was tested positive for SARS-CoV-2 infection 12 day before. Native chest CT scan result was suggestive of a severe COVID-19 pneumonia. Shortly after admission, the patient accused persistent headache located in the right frontal area which evolved bilaterally and it associated periorbital edema later. Based on the cranial CT scan he was diagnosed with acute pansinusitis and periorbital cellulitis. Despite broad spectrum antibiotic and antifungal therapy the inflammatory syndrome was rising and his clinical condition was getting worse. Considering the inflammatory recurrence, his immunosuppressed status caused by COVID-19 and the corticosteroid therapy, his history of diabetes, the cranial CT scan and the extemporaneous histopathological examination, we suspected mucormycosis. So, the patient underwent surgical transosseus drainage of the right sinus and nasal endoscopy with further recommendation of functional endoscopic sinus surgery. The extemporaneous histopathological examination of the samples collected during surgery suggested a presumptive diagnose of mucormycosis. Although right after surgical debridement we started targeted antifungal therapy, his impaired condition required transfer to the intensive care unit.

16.
Orbit ; : 1-7, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1868110

ABSTRACT

We describe two cases of extensive indolent calvarial osteomyelitis after rhino-orbital-mucormycosis in diabetic patients previously diagnosed with COVID-19. Both patients presented with acute rhino-orbital symptoms about one month after being diagnosed with COVID-19. Treatment with intravenous liposomal Amphotericin B and prompt radical surgical debridement was instituted, but calvarial osteomyelitis ensued and persisted chronically despite maintenance of antifungal therapy and partial debridement of necrotic calvarial bone. The patients were discharged to continue antifungal therapy on a day-hospital regime. After more than 8 months of treatment, they remain with radiological signs of osteomyelitis but with no symptoms or intracranial extension of the infection. Calvarial indolent osteomyelitis secondary to mucormycosis is extremely rare, and little is known regarding its treatment. We believe it can be controlled with medical treatment and partial bony debridement although more studies are necessary to better define therapy.

17.
Oral Maxillofac Surg Cases ; 8(2): 100262, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1867640

ABSTRACT

Objective: To explore the literature on corona-associated mucormycosis and explain its relevance to dentists and oral surgeons. Methods: A literature search was carried out to identify reported cases on corona-associated mucormycosis since the start of COVID-19 pandemic. Results: A review of literature identified 265 published papers on CAM between March 2020 and September 2021. Careful screening of abstracts and full texts revealed 29 studies reporting case series of CAM and, 27 case reports on CAM. Conclusions: A multitude of factors may be responsible for the alarming rise in the incidence of corona-associated mycosis including reduced access to routine medical services during the pandemic, injudicious use of antibiotics, steroids and nutritional supplements. Risk factors contributing to corona-associated mucormycosis need to be recognized. Dentists and oral surgeons can contribute to early recognition of corona-associated mucormycosis involving the maxilla, and palate. Prioritizing research focus on optimal management of mucormycosis may reduce the morbidity and mortality associated with this debilitating infection.

18.
JK Science ; 23(4):170-174, 2021.
Article in English | EMBASE | ID: covidwho-1866137

ABSTRACT

Mucormycosis is a serious, but rare opportunistic, invasive and life-threatening fungal infection primarily caused by Rhizopus arrhizus with very high case fatality. Recently, its alarming rise in the number among COVID-19 patients mostly with uncontrolled diabetes and those who received excessive administration of steroids for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has raised interest among the scientific community to learn more about the said disease. The current review describes, its epidemiology, clinical presentation, risk factors, warning signs, diagnostic test and available preventive and treatment modalities for its effective management.

19.
Ann Med Surg (Lond) ; 78: 103889, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1866835

ABSTRACT

Mucormycosis is a rare fungal infection mostly encountered in immunosuppressed patients. Other major risk factors are diabetes mellitus, solid organ transplant and chronic use of glucocorticoids. Early diagnosis should be obtained as soon as possible due to the infection's aggressive behavior and high probability of dissemination. Here we present a case of pulmonary mucormycosis in a non-diabetic patient, known to have systemic lupus erythematous and had a renal transplant recently presented with shortness of breath and was treated with antibiotic as a case of chest infection with minimal improvement. Then, after full investigations, he seemed to have mucormycosis which was successfully treated with combined liposomal amphotericin B and resection of the infectious lesion.

20.
Int Med Case Rep J ; 15: 251-257, 2022.
Article in English | MEDLINE | ID: covidwho-1865385

ABSTRACT

Background: There has been a rise in secondary invasive fungal infections reported in COVID-19 patients globally. We report the first published case of COVID-19 associated rhino-orbital-cerebral mucormycosis in Africa in a newly diagnosed diabetic female who presented with diabetic ketoacidosis (DKA) and discuss the prevalence and risk factors of fungal co-infection with the clinical presentation, diagnosis, and management of mucormycosis in COVID-19. Case Presentation: A 39 years old female patient was admitted to ICU with a diagnosis of severe COVID-19 and newly diagnosed diabetes mellitus (DM) with DKA based on HgbA1c of 13.8% and positive RT-PCR. The patient was treated with dexamethasone in line with evidence in the RECOVERY trial and developed right facial and orbital swelling on her second hospital day. Brain MRI showed characteristic peri-sinonasal invasion with central nervous system (CNS) involvement, features suggestive of invasive fungal infection. Despite all medical and surgical treatments including liposomal amphotericin B and debridement, the patient died within 7 days of symptom onset. Conclusion: Clinicians should be aware of the potential for Rhino-Orbital-Cerebral Mucormycosis (ROCM) as a complication of COVID-19, especially in steroid taking diabetics who develop periorbital swelling and sinusitis. Timely diagnosis and multidisciplinary treatment are very critical.

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