Mucor in a Viral Land: A Tale of Two Pathogens
| Autor: | Tatyarao P Lahane, Santosh G Honavar, Ragini Parekh, Mrittika Sen, Sumeet Lahane |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Posaconazole Opportunistic infection Secondary infection medicine.medical_treatment Comorbidity mucormycosis corticosteroids 03 medical and health sciences 0302 clinical medicine lcsh:Ophthalmology Internal medicine Biopsy medicine Humans Letters to the Editor Pandemics Aged Retrospective Studies medicine.diagnostic_test SARS-CoV-2 business.industry Mucormycosis Immunosuppression Retrospective cohort study Middle Aged medicine.disease Ophthalmology covid-19 lcsh:RE1-994 diabetes mellitus Mucorales 030221 ophthalmology & optometry Original Article Female Histopathology business Eye Infections Fungal 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Indian Journal of Ophthalmology, Vol 69, Iss 2, Pp 244-252 (2021) Indian Journal of Ophthalmology |
| ISSN: | 0301-4738 |
| Popis: | Purpose COVID-19 infection, its treatment, resultant immunosuppression, and pre-existing comorbidities have made patients vulnerable to secondary infections including mucormycosis. It is important to understand the presentation, temporal sequence, risk factors, and outcomes to undertake measures for prevention and treatment. Methods We conducted a retrospective, interventional study on six consecutive patients with COVID-19 who developed rhino-orbital mucormycosis and were managed at two tertiary ophthalmic referral centers in India between August 1 and December 15, 2020. Diagnosis of mucormycosis was based on clinical features, culture, and histopathology from sinus biopsy. Patients were treated with intravenous liposomal amphotericin B with addition of posaconazole and surgical debridement of necrotic tissue. Results All patients were male, mean age 60.5 ± 12 (46.2-73.9) years, type 2 diabetics with mean blood glucose level of 222.5 ± 144.4 (86-404) mg/dL. Except for one patient who was diagnosed with mucormycosis concurrently with COVID-19, all patients received systemic corticosteroids for the treatment of COVID-19. The mean duration between diagnosis of COVID-19 and development of symptoms of mucor was 15.6 ± 9.6 (3-42) days. All patients underwent endoscopic sinus debridement, whereas two patients required orbital exenteration. At the last follow-up, all six patients were alive, on antifungal therapy. Conclusion Mucormycosis is a life-threatening, opportunistic infection, and patients with moderate to severe COVID-19 are more susceptible to it. Uncontrolled diabetes mellitus and use of corticosteroids increase the risk of invasive fungal infection with mucormycosis which can develop during the course of the illness or as a sequelae. High index of suspicion, early diagnosis, and appropriate management can improve survival. |
| Databáze: | OpenAIRE |
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