Invasive pulmonary and sino-orbital mucor mycosis in patient with SARS-Cov-2 infection with diabetic ketoacidosis

Authors

  • Neeraj Singla Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India http://orcid.org/0000-0002-7983-1637
  • Suraj Agrawal Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  • Dimpi Bhankhur Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20212870

Keywords:

Disseminated, Co-infection, Diabetes, COVID-19

Abstract

Patients with Severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) are susceptible for developing fungal infection due to uncontrolled diabetes or immunosuppression. A 46 years male presented with diabetic ketoacidosis, respiratory failure with peri orbital blackish discoloration with SARS-Cov-2 positive report. Computed tomography (CT) chest was suggestive of perihilar ground glass opacity and multiple thick-walled cavities. Left nasal cavity scrapings revealed hyaline aseptate hyphae and growth of Rhizopus arrhizus. Patient was initially managed conservatively with liposomal amphotericin B but later underwent orbital exenteration and finally succumbed. We want to emphasize higher mortality and aggressive management of mucor mycosis when it occurs with SARS-Cov-2 as a concurrent illness.  

Author Biography

Neeraj Singla, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Assistant Professor,

References

Martínez-López R. Ecología de los hongos patógenos para el hombre. Rev Mex Mic. 2005;21:85-92.

Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia. 2020;185:599-606.

Koehler P, Cornely OA, Böttiger BW, Dusse F, Eichenauer DA, Fuchs F et al. COVID-19 associated pulmonary aspergillosis. Mycoses. 2020;63(6):528-34.

Mekonnen ZK, Ashraf DC, Jankowski T, Grob SR, Vagefi MR, Kersten RC et al. Acute Invasive Rhino-Orbital Mucormycosis in a Patient With COVID-19-Associated Acute Respiratory Distress Syndrome. Ophthalmic Plast Reconstr Surg. 2021;37(2):e40-80.

Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A, Puri GD et al. Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature. Mycopathologia. 2021;186(2):289-98.

Gangneux JP, Bougnoux ME, Dannaoui E, Cornet M, Zahar JR. Invasive fungal diseases during COVID-19: We should be prepared. J Mycol Med. 2020;30(2):100971.

Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med. 2021;42:264.e5-4.

Lin E, Moua T, Limper AH. Pulmonary mucormycosis: clinical features and outcomes. Infection. 2017;45:443-8.

Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B et al. Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19(12):e405-21.

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Published

2021-07-23

Issue

Section

Case Reports