Roushdy Tamer, Hamid Eman
Neurology Department, Faculty of Medicine, Ain Shams University, 38 Abbasia, PO 11591, Cairo, Egypt.
Egypt J Neurol Psychiatr Neurosurg. 2021;57(1):100. doi: 10.1186/s41983-021-00355-8. Epub 2021 Jul 26.
Direct neurological manifestations of coronavirus disease whether peripheral or central are reported worldwide. Yet, along the 3rd wave of the pandemic especially in India, an associated angioinvasive opportunistic infection with mucormycosis in COVID-19 cases is emerging.
The current case series which represents 4 patients with mucormycosis post COVID-19 is one of a few if not the first case series that discusses post COVID-19 mucormycosis from a neurological prospective in a tertiary hospital in Egypt.All cases but one presented with total ophthalmoplegia, and only one was diagnosed as a cavernous sinus thrombosis; meanwhile, orbital cellulitis and orbital apex syndrome were responsible of ophthalmoplegia in two cases.Mortality reached 25%, and the case that died suffered cutaneous as well as rhino-cerebral type with a delayed presentation to hospital.
A rare but fatal fungal infection is ought to be nowadays kept in mind in COVID-19 active cases as well as in recovered COVID-19 patients, especially those who have comorbid medical conditions as uncontrolled diabetes and who were treated with large doses of corticosteroids.
冠状病毒病的直接神经表现，无论是外周性还是中枢性，在全球范围内均有报道。然而，在大流行的第三波期间，尤其是在印度，新型冠状病毒肺炎（COVID-19）病例中出现了一种与毛霉菌病相关的血管侵袭性机会性感染。
本病例系列代表4例COVID-19后毛霉菌病患者，是埃及一家三级医院中从神经学角度讨论COVID-19后毛霉菌病的少数病例系列之一，如果不是首个病例系列的话。除1例患者外，所有病例均出现完全性眼肌麻痹，仅1例被诊断为海绵窦血栓形成；同时，眼眶蜂窝织炎和眶尖综合征是2例患者眼肌麻痹的原因。死亡率达25%，死亡病例为皮肤型和鼻脑型，且延迟就医。
如今，在COVID-19活动期病例以及康复的COVID-19患者中，尤其是那些患有如未控制的糖尿病等合并症且接受过大剂量皮质类固醇治疗的患者，应牢记这种罕见但致命的真菌感染。
