Rhinocerebral Mucormycosis as a Sequelae of COVID-19 Treatment: A Case Report &amp; Literature Review

Deek, Andrew; Boukovalas, Stefanos; Rathfoot, Christopher; Gotcher, Jack E.

doi:10.1016/j.joms.2021.09.009

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Human immunodeficiency virus (HIV) infection does not appear to increase the risk of developing mucormycosis probably because neutrophils, as opposed to T lymphocytes, play a major role in defence against Mucorales. New case reports have documented the mucormycosis to be a sequelae of COVID-19 as immune dysfunction, immunosuppressive treatments, and proinflammatory state increase ones risk for this aggressive invasive fungal infection [31]. Our case however, predates the COVID-19 pandemic and as such no PCR testing or screening was done as part of the work up.…”

Section: Discussionmentioning

confidence: 86%

Rhinocerebral Mucormycosis Case Report and Brief Review of the Literature

Chan¹

2023

Open Access J Dent Oral Surg

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The purpose of this paper is to present a case report of rhinocerebral mucormycosis in the setting of uncontrolled diabetes mellitus in which the patient underwent aggressive surgical and medical treatment. The outcome of the case was a success with the patient surviving despite having intracranial involvement which was left untouched. In addition to presenting the case, we will review the literature in regards to invasive fungal infections of the maxillofacial region, its various presentations, therapeutic modalities, and outcomes of treatment. Our goal is to share our experience and provide a review of literature to help provide a foundation of knowledge upon which clinicians can identify and rapidly treat maxillofacial cases of mucormycosis.

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Section: Discussionmentioning

confidence: 86%

Rhinocerebral Mucormycosis Case Report and Brief Review of the Literature

Chan¹

2023

Open Access J Dent Oral Surg

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“…Other medications such as Isavuconazole or Posaconazole have been used in cases with invasive mucormycosis (22). Second, bone and soft-tissue repair by surgery can also be considered (23).…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 rhinocerebral mucormycosis, a life-threatening event in the background of immunosuppressive condition: A case report

Tajik

Chegini

2023

Preprint

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Introduction: In patients suffering from COVID-19, immunocompromised conditions or immunosuppressive medications such as corticosteroids may predispose them to early or delayed invasive fungal infections that invade cerebral components. This study, for the first time, describes a case of COVID-19 disease diagnosed with rhinocerebral mucormycosis through cerebrospinal fluid (CSF) analysis. Case presentation: A 32-year-old woman with a history of referral and hospitalization due to COVID-19 about a month ago was being treated with immunosuppressive drugs, manifested by lower extremity plegia. In the imaging assessment, intracranial hemorrhage (thalamus zone) and mass like lesion were revealed. In cytological assessment, acute inflammations associated with fungal infection in accordance with the diagnosis of mucormycosis were definitively confirmed. Despite antifungal medication, consciousness declined one week later, and the patient developed thromboembolism and died. Conclusion In patients with a COVID-19 background of immunosuppressive therapy or clinical situations related to immunosuppression such as uncontrolled diabetes, rhinocerebral mucormycosis will always be an ambush. Therefore, screening and prevention measures should be considered.

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“…Cases of secondary fungal co-infections in COVID-19 patients mainly occurred during the second wave of the disease. In the same period, the World Health Organization (WHO) recommended corticosteroid use in critically ill COVID-19 patients [3][4][5] . Moreover, other risk factors were also associated with the development of fungal co-infections during SARS-CoV-2 infection, namely: diabetes mellitus, immunodeficiencies, hypertension, and cardiovascular diseases, among others 3,5 .…”

Section: Coronavirus Disease -2019 (Covid-19) Is An Infection Caused Bymentioning

confidence: 99%

“…These cases may be directly associated with corticosteroid use in this group. This hypothesis is justified since these drugs can cause an uncontrolled release of sugar, which helps the growth and accelerated replication of fungi, in addition to suppressing the immune system, the main defense of the host against infections 4 .…”

Section: Main Fungal Co-infections In Covid-19 Patientsmentioning

confidence: 99%

Corticosteroid therapy associated with Covid-19: an ally or a risk factor for the establishment of secondary fungal co-infections?

Amaral

Coutinho

Fuentefria

et al. 2023

CBR

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Corticosteroid therapy to combat inflammation caused by SARS-CoV-2 seems to be a risk factor for developing secondary fungal co-infections. PubMed and ScienceDirect databases were searched, with the following word groups: [(aspergillosis OR mucormycosis OR candidiasis) AND (coronavirus disease) AND (corticoids). The selected articles present the main risk factors related to the establishment of secondary fungal co-infections in COVID-19 patients. Corticosteroid therapy used to combat inflammation caused by SARS-CoV-2 has been shown to be strongly associated with the establishment of mucormycosis and aspergillosis. Mucormycosis has been the main fungal co-infection related to corticosteroid therapy, causing a high number of deaths in COVID-19 patients. Diabetes mellitus was the most prevalent comorbidity, especially for the establishment of mucormycosis. Dexamethasone use seems to be associated with mucormycosis emergence and death. However, aspergillosis showed a greater relationship with patient recovery. Thus, risk factors such as diabetes mellitus, combined with corticosteroid use, have shown a relationship to the establishment of mucormycosis. The corticosteroids used in COVID-19 patients should be individually analyzed, considering the patient's medical history and the risk/ benefit ratio of the use of these drugs.

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Rhinocerebral Mucormycosis as a Sequelae of COVID-19 Treatment: A Case Report & Literature Review

Cited by 7 publications

References 20 publications

Rhinocerebral Mucormycosis Case Report and Brief Review of the Literature

Rhinocerebral Mucormycosis Case Report and Brief Review of the Literature

Post-COVID-19 rhinocerebral mucormycosis, a life-threatening event in the background of immunosuppressive condition: A case report

Corticosteroid therapy associated with Covid-19: an ally or a risk factor for the establishment of secondary fungal co-infections?

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