Case Report: COVID-19-associated Rhinosinusitis Mucormycosis Caused by Rhizopus arrhizus: A Rare but Potentially Fatal Infection Occurring After Treatment with Corticosteroids

Tabarsi, Payam; Khalili, Nastaran; Pourabdollah, Mihan; Sharifynia, Somayeh; Naeini, Ali Safavi; Ghorbani, Jahangir; Mohamadnia, Abdolreza; Abtahian, Zahra; Askari, Elham

doi:10.4269/ajtmh.21-0359

Cited by 24 publications

(15 citation statements)

References 21 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On analyzing the sources of the reported cases, India was the most contributing country (55.5%) [46][47][48][49][50]58,69,77,[80][81][82][84][85][86][87][88], followed by Egypt (17.8%) [72,74], Iran (9.9%) [63,64,70,78], Turkey (6.3%) [65,71], and the United States of America (4.7%) [52][53][54][55][56][57]59,75,76]. See Figure 4.…”

Section: Demographic Characteristicsmentioning

confidence: 99%

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

Riad

Shabaan

Issa

et al. 2021

JoF

View full text Add to dashboard Cite

Background: Since the novel coronavirus disease (COVID-19) outbreak, the cases of COVID-19 co-infections have been increasingly reported worldwide. Mucormycosis, an opportunistic fungal infection caused by members of the Mucorales order, had been frequently isolated in severely and critically ill COVID-19 patients. Methods: Initially, the anamnestic, clinical, and paraclinical features of seven COVID-19-associated mucormycosis (CAM) cases from Egypt were thoroughly reported. Subsequently, an extensive review of the literature was carried out to describe the characteristics of CAM cases globally, aiming to explore the potential risk factors of mortality in CAM patients. Results: Out of the seven reported patients in the case series, five (71.4%) were males, six (85.7%) had diabetes mellitus, and three (42.9%) had cardiovascular disease. All patients exhibited various forms of facial deformities under the computed tomography scanning, and two of them tested positive for Mucorales using the polymerase chain reaction (PCR) testing. Liposomal amphotericin B (LAmB) was prescribed to all cases, and none of them died until the end of the follow-up. On reviewing the literature, 191 cases were reported worldwide, of which 74.4% were males, 83.2% were from low-middle income countries, and 51.4% were aged 55 years old or below. Diabetes mellitus (79.1%), chronic hypertension (30%), and renal disease/failure (13.6%) were the most common medical comorbidities, while steroids (64.5%) were the most frequently prescribed medication for COVID-19, followed by Remdesivir (18.2%), antibiotics (12.7%), and Tocilizumab (5.5%). Conclusions: As the majority of the included studies were observational studies, the obtained evidence needs to be interpreted carefully. Diabetes, steroids, and Remdesivir were not associated with increased mortality risk, thus confirming that steroids used to manage severe and critical COVID-19 patients should not be discontinued. Lung involvement, bilateral manifestation, and Rhizopus isolation were associated with increased mortality risk, thus confirming that proactive screening is imperative, especially for critically ill patients. Finally, surgical management and antimycotic medications, e.g., amphotericin B and posaconazole, were associated with decreased mortality risk, thus confirming their effectiveness.

show abstract

Section: Demographic Characteristicsmentioning

confidence: 99%

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

Riad

Shabaan

Issa

et al. 2021

JoF

View full text Add to dashboard Cite

show abstract

“…Nevertheless, the incidence of mucormycosis in patients having or recovering from COVID-19 has been escalating throughout the world. Multiple CAM case reports from United States, Pakistan, Iran, Mexico and single case reports from Brazil and Chile have been published ( Khan et al, 2020 ; Monte Junior et al, 2020 ; Rabagliati et al, 2021 ; Shakir et al, 2021 ; Tabarsi et al, 2021 ; Guzmán-Castro et al, 2022 ). In Europe, CAM cases have been reported from Austria, Germany, Spain, Czech Republic, France, Italy, the Netherlands and the United Kingdom ( Hanley et al, 2020 ; Arana et al, 2021 ; Bellanger et al, 2021 ; Buil et al, 2021 ; Pasero et al, 2021 ; Zurl et al, 2021 ; Danion et al, 2022 ; Hoenigl et al, 2022 ; Seidel et al, 2022 ).…”

Section: Mucormycosismentioning

confidence: 99%

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

Domán

Bányai

2022

Front. Microbiol.

View full text Add to dashboard Cite

Secondary fungal infections may complicate the clinical course of patients affected by viral respiratory diseases, especially those admitted to intensive care unit. Hospitalized COVID-19 patients are at increased risk of fungal co-infections exacerbating the prognosis of disease due to misdiagnosis that often result in treatment failure and high mortality rate. COVID-19-associated fungal infections caused by predominantly Aspergillus and Candida species, and fungi of the order Mucorales have been reported from several countries to become significant challenge for healthcare system. Early diagnosis and adequate antifungal therapy is essential to improve clinical outcomes, however, drug resistance shows a rising trend highlighting the need for alternative therapeutic agents. The purpose of this review is to summarize the current knowledge on COVID-19-associated mycoses, treatment strategies and the most recent advancements in antifungal drug development focusing on peptides with antifungal activity.

show abstract

“…The ocular examination involves testing for visual acuity, pupil and ocular motility, extraocular abnormalities, and examination of the fundus and biomicroscopy [52,57]. Abnormalities such as ophthalmoplegia, proptosis, blepharoptosis, affected visual acuity and perception of light, oedema and necrosis have been commonly observed in mucormycosis patients [58][59][60]. Intra oral examination should be performed to evaluate the presence of tooth mobility, swelling, tenderness and bone exposure [61].…”

Section: Clinical Examinationmentioning

confidence: 99%

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Madhavan

Sai

Shanmugam

et al. 2022

JCM

View full text Add to dashboard Cite

Mucormycosis has become increasingly associated with COVID-19, leading to the use of the term “COVID-19 associated mucormycosis (CAM)”. Treatment of CAM is challenging due to factors such as resistance to many antifungals and underlying co-morbidities. India is particularly at risk for this disease due to the large number of patients with COVID-19 carrying comorbidities that predispose them to the development of mucormycosis. Additionally, mucormycosis treatment is complicated due to the atypical symptoms and delayed presentation after the resolution of COVID-19. Since this disease is associated with increased morbidity and mortality, early identification and diagnosis are desirable to initiate a suitable combination of therapies and control the disease. At present, the first-line treatment involves Amphotericin B and surgical debridement. To overcome limitations associated with surgery (invasive, multiple procedures required) and amphotericin B (toxicity, extended duration and limited clinical success), additional therapies can be utilized as adjuncts or alternatives to reduce treatment duration and improve prognosis. This review discusses the challenges associated with treating CAM and the critical aspects for controlling this invasive fungal infection—early diagnosis and initiation of therapy, reversal of risk factors, and adoption of a multipronged treatment strategy. It also details the various therapeutic options (in vitro, in vivo and human case reports) that have been used for the treatment of CAM.

show abstract

Case Report: COVID-19-associated Rhinosinusitis Mucormycosis Caused by Rhizopus arrhizus: A Rare but Potentially Fatal Infection Occurring After Treatment with Corticosteroids

Cited by 24 publications

References 21 publications

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

COVID-19-Associated Mucormycosis (CAM): Case-Series and Global Analysis of Mortality Risk Factors

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Contact Info

Product

Resources

About