A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil

Dantas, Kátia Cristina; Mauad, Thaís; André, Carmen Diva Saldiva de; Bierrenbach, Ana Luiza; Saldiva, Paulo Hilário Nascimento

doi:10.1038/s41598-021-83587-1

Cited by 26 publications

(21 citation statements)

References 59 publications

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“…Differentiation of species based on morphology only is not possible 26 . This perpetual dilemma results in underestimation of invasive fungal infections also in non‐pandemic times as several autopsy studies have shown 14,27 …”

Section: Discussionmentioning

confidence: 99%

Results from a national survey on COVID‐19‐associated mucormycosis in Germany: 13 patients from six tertiary hospitals

Seidel

Simon

Sprute

et al. 2021

Mycoses

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Background Most COVID‐19‐associated mucormycosis (CAM) cases are reported from India and neighbouring countries. Anecdotally cases from Europe have been presented. Objective To estimate the disease burden and describe the clinical presentation of CAM in Germany. Methods We identified cases through German mycology networks and scientific societies, and collected anonymised clinical information via FungiScope®. Results We identified 13 CAM cases from six tertiary referral hospitals diagnosed between March 2020 and June 2021. Twelve patients had severe or critical COVID‐19, eleven were mechanically ventilated for a median of 8 days (range 1‐27 days) before diagnosis of CAM. Eleven patients received systemic corticosteroids. Additional underlying medical conditions were reported for all but one patient, five were immunocompromised because of malignancy or organ transplantation, three were diabetic. Eleven patients developed pneumonia. Mortality was 53.8% with a median time from diagnosis of mucormycosis to death of 9 days (range 0–214 days) despite treatment with liposomal amphotericin B and/or isavuconazole in 10 of 13 cases. CAM prevalence amongst hospitalised COVID‐19 patients overall (0.67% and 0.58% in two centres) and those admitted to the intensive care unit (ICU) (1.47%, 1.78% and 0.15% in three centres) was significantly higher compared to non‐COVID‐19 patients (P < .001 for respective comparisons). Conclusion COVID‐19‐associated mucormycosis is rare in Germany, mostly reported in patients with comorbidities and impaired immune system and severe COVID‐19 treated in the ICU with high mortality compared to mainly rhino‐orbito‐cerebral CAM in patients with mild COVID‐19 in India. Risk for CAM is higher in hospitalised COVID‐19 patients than in other patients.

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Section: Discussionmentioning

confidence: 99%

Results from a national survey on COVID‐19‐associated mucormycosis in Germany: 13 patients from six tertiary hospitals

Seidel

Simon

Sprute

et al. 2021

Mycoses

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“…Hong et al also found that disseminated infection leading to sepsis correlated with an increased risk of death in mucormycosis patients [23]. Other studies have shown that other underlying conditions predispose individuals to the infection, including trauma, burns, intravenous drug use, use of broad-spectrum antibiotics, increases in iron or ferritin in the system, malnutrition, and use of voriconazole [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Postoperative ICU Admission in Patients With COVID-19-Associated Mucormycosis

Gupta¹,

Yadav²,

Chilkoti³

et al. 2022

Cureus

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Background: Studies exploring factors predicting postoperative ICU requirement in patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) were not found in the literature. The aim was to evaluate the demographic profile, comorbidities, pattern of steroid received, airway assessment, and intraoperative hemodynamic perturbations associated with ICU requirement amongst patients scheduled for sinonasal debridement.Methods: This is a retrospective cohort study. All CAM patients of ≥18 years were included. The patients' characteristics, comorbidities, pattern of steroid received, airway assessment, intraoperative hemodynamic perturbations, and outcome data were retrieved.Results: A total of 130 patients were included. Thirty got admitted to ICU, out of which 26 expired. Amongst the various comorbidities, diabetes was the most common (93.85%) and was associated with higher chances of ICU requirement. Of patients with a history of steroid intake, 71% had a significantly higher risk of ICU admission. Out of 30 patients admitted to ICU, 87% (n=26) received invasive ventilation, and the rest were admitted for observation only.Conclusion: Middle age, uncontrolled diabetes, history of steroid intake, increased levels of serum creatinine with low potassium, and increased total leucocyte count are the independent risk factors predicting postoperative ICU admission amongst patients with CAM scheduled for sinonasal debridement.

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“…Some common predisposing factors include immunocompromised with neutropenia, organ or stem cell transplantation, renal insufficiency, broad spectrum antibiotics or prophylactic voriconazole, malnutrition, iron overload, prolonged use of steroids, and diabetes with or without ketoacidosis. [4] The prognosis is substantially better if the infection has not spread beyond the sinuses prior to the surgery. In local sinonasal disease, mortality has been reported as, 10 per cent.…”

Section: Introductionmentioning

confidence: 99%

Acute Fulminant Rhinocerebral Mucormycosis: A Case Report with Review of Management

Khan

Deshmukh

Gaurkar

2024

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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Rhinocerebral mucormycosis is an uncommon, rapidly advancing, catastrophic, opportunistic fungal infection that predominantly affects metabolic and/or immunologically challenged individuals. Its frequency has increased dramatically since the SARS-COV-19 epidemic. The disease has been described as having distinct clinical categories, namely: rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated. Extranasal dissemination has been invariably linked with an increased risk of death. Though an aggressive disease with a substantial rate of mortality, seeking timely help, prompt investigations and diagnosis, treatment with higher antibiotics, oral or intravenous antifungals, rigorous surgical excision, and control of underlying comorbidities has resulted in effective disease management and control with a gratifying outcome and lower morbidity when compared to the pre COVID era. We present a case of sinonasal mucormycosis with ocular, oral, pulmonary, and intracranial involvement in a young post COVID-19 immunocompromised male patient who was optimally treated with a comprehensive endoscopic surgical approach and combined with oral and systemic liposomal amphotericin B therapy.

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A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil

Cited by 26 publications

References 59 publications

Results from a national survey on COVID‐19‐associated mucormycosis in Germany: 13 patients from six tertiary hospitals

Results from a national survey on COVID‐19‐associated mucormycosis in Germany: 13 patients from six tertiary hospitals

Predictors of Postoperative ICU Admission in Patients With COVID-19-Associated Mucormycosis

Acute Fulminant Rhinocerebral Mucormycosis: A Case Report with Review of Management

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