Alekseyev Kirill, Didenko Lidiya, Chaudhry Bilal
Post-Acute Medical Rehabilitation Hospital of Dover, 1240 McKee Road, Dover, DE 19904, USA.
Christiana Care Health System, 4755 Ogletown Stanton Road, Newark, DE 19718, USA.
J Med Cases. 2021 Mar;12(3):85-89. doi: 10.14740/jmc3637. Epub 2021 Jan 19.
As the coronavirus disease 2019 (COVID-19) pandemic is evolving, more complications associated with COVID-19 are emerging. In this case report, we present a case of rhinocerebral mucormycosis concurrent with COVID-19 pneumonia in a 41-year-old man with a history of type 1 diabetes mellitus (T1DM). COVID-19 pneumonia was diagnosed with reverse transcription-polymerase chain reaction (RT-PCR). He was promptly treated with steroids and hydroxychloroquine, as this was the recommended regional COVID-19 practice patterns at the time. He was treated with intravenous (IV) fluids and an insulin drip for his diabetic ketoacidosis (DKA), cefepime and IV abelcet, along with three surgical debridements for the rhinocerebral mucormycosis. The pneumonia resolved during the course of his stay in the hospital. With prompt diagnosis and treatment of rhinocerebral mucormycosis, the patient was cleared for discharge and was instructed to complete his course of treatment with coumadin and IV abelcet at home. Saprophytic fungi cause rhinocerebral mucormycosis, a rare opportunistic infection of the sinuses, nasal passages, oral cavity and brain. It usually occurs in patients with poorly controlled diabetes mellitus or those who are immunocompromised, which is again demonstrated in this case report. In the setting of COVID-19 pneumonia and an underlying condition, healthcare professionals should act promptly. In cases where mucormycosis infection is suspected, a prompt diagnosis and treatment should be started because of the angioinvasive character and rapid disease progression that contribute to the severity of the mucormycosis infection.
随着2019冠状病毒病（COVID-19）大流行的演变，与COVID-19相关的更多并发症正在出现。在本病例报告中，我们介绍了一名41岁1型糖尿病（T1DM）病史男性并发COVID-19肺炎的鼻脑毛霉菌病病例。通过逆转录聚合酶链反应（RT-PCR）诊断为COVID-19肺炎。由于当时这是推荐的地区性COVID-19治疗模式，他立即接受了类固醇和羟氯喹治疗。他因糖尿病酮症酸中毒（DKA）接受了静脉输液和胰岛素滴注治疗，使用了头孢吡肟和静脉注射两性霉素B脂质体，同时对鼻脑毛霉菌病进行了三次手术清创。肺炎在他住院期间得到缓解。经过对鼻脑毛霉菌病的及时诊断和治疗，患者获准出院，并被指示在家中完成华法林和静脉注射两性霉素B脂质体的疗程。腐生真菌引起鼻脑毛霉菌病，这是一种罕见的鼻窦、鼻腔、口腔和脑部机会性感染。它通常发生在糖尿病控制不佳或免疫功能低下的患者中，本病例报告再次证明了这一点。在COVID-19肺炎和潜在疾病的情况下，医护人员应迅速采取行动。在怀疑毛霉菌病感染的病例中，由于其血管侵袭性和疾病进展迅速，会导致毛霉菌病感染的严重性，应迅速进行诊断和治疗。
