Background COVID-19 disease may be associated with a wide range of bacterial and fungal infections. We report a patient with COVID-19 infection who developed rhino-facial mucormycosis during treatment with corticosteroids. Case presentation A 59-year-old non-diabetic male patient was admitted with a diagnosis of COVID-19 based on positive RT-PCR and CT of the lungs. Due to sever lung involvement, he was treated with methylprednisolone. The patient was re-admitted to hospital, due to nasal obstruction and left side facial and orbital swelling, several days after discharge. In sinus endoscopic surgery, debridement was performed and the specimens were sent to pathology and mycology laboratories. A nasal biopsy showed wide hyphae without septa. The sequenced PCR product revealed Rhizopus oryzae . Despite all medical and surgical treatment, the patient died. In addition, the characteristics of patients with COVID-19-associated mucormycosis were reviewed in 44 available literatures. In most studies, diabetes mellitus was the most common predisposing factor for mucormycosis. Conclusion Our report highlights the need for assessing the presence of mucormycosis in patients with COVID-19 and also it shows that physicians should consider the potential for secondary invasive fungal infections in COVID-19 cases.
All Keywords
【저자키워드】 COVID-19, Mucormycosis, Rhizopus oryzae, 【초록키워드】 Methylprednisolone, Treatment, pathology, Corticosteroids, lung involvement, hospital, Infection, Diabetes Mellitus, nasal, surgical, diabetes, discharge, COVID-19 disease, COVID-19 infection, Mucormycosis, Lungs, male, Patient, fungal infections, Bacterial, positive RT-PCR, COVID-19 cases, Fungal infection, predisposing factor, surgical treatment, nasal obstruction, during treatment, specimen, bacterial and fungal infections, side, physician, debridement, septa, hyphae, patient with COVID-19, invasive, highlight, sequenced, died, the patient, addition, was performed, treated, PCR product, characteristics of patient, diagnosis of COVID-19, facial, patients with COVID-19, Rhizopus, 【제목키워드】 systematic review, Case report, Patient,
배경 COVID-19 질병은 광범위한 박테리아 및 곰팡이 감염과 관련될 수 있습니다. 우리는 코르티코스테로이드로 치료하는 동안 코안면 점막진균증이 발생한 COVID-19 감염 환자를 보고합니다. 증례발표 59세 비당뇨병 남자 환자가 폐의 RT-PCR 및 CT 검사에서 코로나19로 진단되어 입원하였다. 심각한 폐 침범으로 인해 그는 메틸프레드니솔론으로 치료를 받았습니다. 환자는 퇴원 후 수일 만에 코막힘과 왼쪽 안면부 및 안와 부종으로 다시 병원에 입원하였다. 부비동 내시경 수술에서는 괴사 조직 절제술을 시행하고 검체를 병리학 및 균류학 실험실로 보냈습니다. 비강 생검에서 격벽이 없는 넓은 균사를 보였다. 염기서열분석 결과 Rhizopus oryzae 가 밝혀졌습니다. 모든 의학적, 외과적 치료에도 불구하고 환자는 사망했습니다. 또한 44개의 이용 가능한 문헌에서 COVID-19 관련 점막진균증 환자의 특성을 검토했습니다. 대부분의 연구에서 진성 당뇨병은 진균증의 가장 흔한 소인이었습니다. 결론 우리의 보고서는 COVID-19 환자에서 점막진균증의 존재를 평가할 필요성을 강조하고 또한 의사가 COVID-19 사례에서 이차 침습성 진균 감염의 가능성을 고려해야 함을 보여줍니다.