Pulmonary Mucormycosis: A Case Report of a Rare Infection with Potential Diagnostic Problems

Mekki, Salwa O.; Hassan, Amal Ali; Falemban, Afnan Hisham; Alkotani, Nashwa; Alsharif, Salem M.; Haron, Ahmed; Felemban, Basim; Iqbal, Mohammad; Tabassum, Aisha

doi:10.1155/2020/5845394

Cited by 25 publications

(25 citation statements)

References 28 publications

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“…One patient diagnosed with pulmonary mucormycosis in our series was also receiving treatment for tuberculosis, also succumbed to his illness. We found two case reports with one patient in each, diagnosed with pulmonary mucormycosis (Mekki et al and Passer et al), with none of them surviving [ 28 , 29 ]. An interesting observation is that the number of pulmonary mucormycosis cases reported is less in comparison to other sites.…”

Section: Discussionmentioning

confidence: 99%

Coronavirus Disease-Associated Mucormycosis from a Tertiary Care Hospital in India: A Case Series

Singh¹,

Ganesh²,

Kumar³

et al. 2021

Cureus

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Background: Coronavirus disease (COVID-19) remains a health concern with new challenges emerging as the pandemic progresses. The recent rise of opportunistic infections especially mucormycosis in COVID-19 patients is further complicating their outcomes. Mucormycosis is well known to infect patients with diabetes mellitus, malignancy, chemotherapy, and other immunocompromised conditions. The treatment of COVID-19 largely remains systemic steroids and other immunomodulators that add to the risk of invasive fungal infection.Methodology: Here, we present a retrospective case series of 13 patients with individual clinical characteristics along with the demography and treatment details. The data were collected retrospectively in a single center that caters to a large population of COVID-19 patients with varying severity.Results: Thirteen patients were presented with COVID-19 associated mucormycosis (CAM). The median age was higher in non-survivors (49.5 years), with a higher odds of death (23.8) in those with severe COVID, having overall mortality of 64.3%. Moreover, diabetes mellitus was present in 61.5% of patients with a mortality of 75%. About 11 (84.6%) patients had received prior steroids for COVID-19. The incidence of hyperglycemia at admission was equal among both survivors and non-survivors. Conclusion:The prevalence of mucormycosis seems to be increasing among COVID-19 patients which may be associated with increased use of steroids, the possible immunocompromised state imposed by SARS-CoV-2, or co-existing conditions such as diabetes mellitus. The mortality of CAM is remarkably high and apart from preventive practices and rational use of immunomodulators, a high index of suspicion with early diagnosis would be key to survival.

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Section: Discussionmentioning

confidence: 99%

Coronavirus Disease-Associated Mucormycosis from a Tertiary Care Hospital in India: A Case Series

Singh¹,

Ganesh²,

Kumar³

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…There are cases reported in the literature where post-tubercular cavity in the lung with a Mucor fungal ball was treated using liposomal AmB. 19 Though Aspergillus is the most common fungus causing the formation of a fungal ball, only 5 case reports (delineating 8 patients) of paranasal fungal balls caused by Mucor has been published in the literature. 20 It should be noted that there are some reports where invasive pulmonary Aspergillus and Mucor was countered adequately using high doses of liposomal AmB alone.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Aspergillus and Mucor Co-Infection

Rajaram

et al. 2021

Sultan Qaboos Univ Med J

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Co-infections or consecutive infections of mucormycosis and aspergillosis are very rare. Additionally, distinguishing between these two infections is also difficult as both these conditions have similar clinical features. We report two similar cases from Tamilnadu, who presented to a tertiary care centre in Puducherry, India in 2017 (first case) and 2019 (second case).The first case was a 70-year-old, non-diabetic male patient who presented with haemoptysis with a prior history of pulmonary tuberculosis. Computed tomography bronchial angiography revealed an air-crescent sign and the histopathological examination showed a fungal ball (aspergillus and mucor) in the upper lobe and foci of fungal infection in the middle lobe. The second case was a 65-year-old diabetic male patient who presented with blackish expectoration and haemoptysis. A high-resolution computed tomography scan showed a reverse-halo sign in the right upper lobe. The results of the bronchoscopy-guided biopsy were consistent with a diagnosis of mixed mucormycosis and aspergillosis with angioinvasion. Both patients responded to amphotericin B with surgical excision of the affected lobe in the first case.A high degree of clinical suspicion, early surgical intervention and antifungal therapy are essential in the treatment of this rare co-infection. Keywords:Aspergillosis; Mucormycosis; Bronchoscopy; Coinfection; Amphotericin B; Case Report; India.

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“…There are cases reported in the literature where posttubercular cavity in the lung with a Mucor fungal ball was treated using liposomal AmB. 19 Though Aspergillus is the most common fungus causing the formation of a fungal ball, only 5 case reports (delineating 8 patients) of paranasal fungal balls caused by Mucor have been published in the literature. 20 It should be noted that there are some reports where invasive pulmonary Aspergillus and Mucor were countered adequately using high doses of liposomal AmB alone.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Aspergillus and Mucor Co-Infection

Ravindra

Rajaram

et al. 2021

Sultan Qaboos Univ Med J

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Co-infections or consecutive infections of mucormycosis and aspergillosis are very rare. Additionally, distinguishing between these two infections is also difficult as both these conditions have similar clinical features. We report two similar cases from Tamilnadu, who presented to a tertiary care centre in Puducherry, India in 2017 (first case) and 2019 (second case). The first case was a 70-year-old, non-diabetic male patient who presented with haemoptysis with a prior history of pulmonary tuberculosis. Computed tomography bronchial angiography revealed an air-crescent sign and the histopathological examination showed a fungal ball (aspergillus and mucor) in the right upper lobe and foci of fungal infection in the middle lobe. The second case was a 65-year-old diabetic male patient who presented with blackish expectoration and haemoptysis. A high-resolution computed tomography scan showed a reverse-halo sign in the right upper lobe. The results of the bronchoscopy-guided biopsy were consistent with a diagnosis of mixed mucormycosis and aspergillosis with angioinvasion. Both patients responded to amphotericin B with surgical excision of the affected lobe in the first case. A high degree of clinical suspicion, early surgical intervention and antifungal therapy are essential in the treatment of this rare co-infection. Keywords: Aspergillosis; Mucormycosis; Bronchoscopy; Coinfection; Amphotericin B; Case Report; India.

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Pulmonary Mucormycosis: A Case Report of a Rare Infection with Potential Diagnostic Problems

Cited by 25 publications

References 28 publications

Coronavirus Disease-Associated Mucormycosis from a Tertiary Care Hospital in India: A Case Series

Coronavirus Disease-Associated Mucormycosis from a Tertiary Care Hospital in India: A Case Series

Pulmonary Aspergillus and Mucor Co-Infection

Pulmonary Aspergillus and Mucor Co-Infection

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