Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature.
Deepak GargValliappan MuthuInderpaul Singh SehgalRaja RamachandranHarsimran KaurAshish BhallaGoverdhan D PuriArunaloke ChakrabartiRitesh AgarwalPublished in: Mycopathologia (2021)
Severe coronavirus disease (COVID-19) is currently managed with systemic glucocorticoids. Opportunistic fungal infections are of concern in such patients. While COVID-19 associated pulmonary aspergillosis is increasingly recognized, mucormycosis is rare. We describe a case of probable pulmonary mucormycosis in a 55-year-old man with diabetes, end-stage kidney disease, and COVID-19. The index case was diagnosed with pulmonary mucormycosis 21 days following admission for severe COVID-19. He received 5 g of liposomal amphotericin B and was discharged after 54 days from the hospital. We also performed a systematic review of the literature and identified seven additional cases of COVID-19 associated mucormycosis (CAM). Of the eight cases included in our review, diabetes mellitus was the most common risk factor. Three subjects had no risk factor other than glucocorticoids for COVID-19. Mucormycosis usually developed 10-14 days after hospitalization. All except the index case died. In two subjects, CAM was diagnosed postmortem. Mucormycosis is an uncommon but serious infection that complicates the course of severe COVID-19. Subjects with diabetes mellitus and multiple risk factors may be at a higher risk for developing mucormycosis. Concurrent glucocorticoid therapy probably heightens the risk of mucormycosis. A high index of suspicion and aggressive management is required to improve outcomes.
Keyphrases
- coronavirus disease
- sars cov
- risk factors
- respiratory syndrome coronavirus
- pulmonary hypertension
- type diabetes
- stem cells
- cardiovascular disease
- adipose tissue
- early onset
- metabolic syndrome
- emergency department
- squamous cell carcinoma
- drug induced
- mesenchymal stem cells
- rectal cancer
- replacement therapy
- prognostic factors
- smoking cessation