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Invasive Mucormycosis and Aspergillosis Coinfection Associated with Post-COVID-19 Pneumonia in a Tertiary Care Hospital.
Paul, Mousumi; Sasidharan, Jaseetha; Taneja, Juhi; Chatterjee, Kuhu; Abbas, S Zafar; Chowdhury, Veena; Das, Asim.
  • Paul M; Department of Microbiology, ESIC Medical College and Hospital.
  • Sasidharan J; Department of ENT, ESIC Medical College and Hospital.
  • Taneja J; Department of Microbiology, ESIC Medical College and Hospital.
  • Chatterjee K; Department of Microbiology, ESIC Medical College and Hospital.
  • Abbas SZ; Department of Radiology, ESIC Medical College and Hospital.
  • Chowdhury V; Department of Radiology, ESIC Medical College and Hospital.
  • Das A; Dean, ESIC Medical College and Hospital.
Med Mycol J ; 63(3): 59-64, 2022.
Article Dans Anglais | MEDLINE | ID: covidwho-2198582
ABSTRACT
Acute invasive fungal rhinosinusitis is a rare infection primarily affecting patients with co-morbidities like immunosuppression and poorly controlled diabetes. Mucormycosis is increasingly being reported in patients with SARS-CoV-2 (COVID-19). However, reports of coinfection of aspergillosis and mucormycosis involving nose, paranasal sinuses, orbit, and brain are rare in literature. We aimed to evaluate the patient demographics, clinical presentation, and management of cases presenting with mixed infection. We carried out retrospective analysis of 12 patients with confirmed diagnosis of mixed invasive fungal infections post-COVID-19 disease out of 70 cases of COVID-19-associated mucormycosis (CAM) presenting to a tertiary-level hospital in North India from May to June 2021. All patients had diabetes mellitus; the mean age was 48 years. The common presenting features were headache, nasal congestion, palatal ulcer, and vision loss accompanied by facial pain and swelling. Two patients developed cerebral abscess during the course of treatment; three patients had concurrent COVID-19 pneumonia. All patients received systemic liposomal amphotericin B and serial surgical debridements. The overall mortality rate was 16.7%. Our study demonstrates that mucormycosis and aspergillosis are angioinvasive mycoses that are clinically and radiologically identical. KOH direct mount of clinical sample showing septate hyphae should be extensively searched for aseptate hyphae after digestion and clearing of the tissue. A high index of suspicion of mixed infection post-COVID-19 and early initiation of liposomal amphotericin B followed by prompt surgical intervention can reduce the overall morbidity and mortality among patients with this condition.
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Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Aspergillose / Sinusite / Co-infection / Infections fongiques invasives / COVID-19 / Mucormycose Type d'étude: Étude diagnostique / Études expérimentales / Étude observationnelle / Étude pronostique Les sujets: Covid long Limites du sujet: Humains / Adulte d'âge moyen langue: Anglais Revue: Med Mycol J Thème du journal: Microbiologie Année: 2022 Type de document: Article

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Texte intégral: Disponible Collection: Bases de données internationales Base de données: MEDLINE Sujet Principal: Aspergillose / Sinusite / Co-infection / Infections fongiques invasives / COVID-19 / Mucormycose Type d'étude: Étude diagnostique / Études expérimentales / Étude observationnelle / Étude pronostique Les sujets: Covid long Limites du sujet: Humains / Adulte d'âge moyen langue: Anglais Revue: Med Mycol J Thème du journal: Microbiologie Année: 2022 Type de document: Article