Barman Roy Debarchan, Gupta Vandana, Biswas Ashutosh, Verma Mansi
Medicine, All India Institute of Medical Sciences, New Delhi, IND.
Dentistry, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2021 Aug 14;13(8):e17178. doi: 10.7759/cureus.17178. eCollection 2021 Aug.
Mucormycosis is an invasive fungal infection occurring in patients with or without preexisting medical illnesses. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, there have been increasing reports of bacterial and fungal coinfections among some COVID-19 patients with preexisting comorbid illnesses such as diabetes and hypertension, with mucormycosis being one of them. The management of this dreaded fungal infection demands early and prompt surgical intervention to thoroughly remove the infected tissue and necrotic material to reduce the tissue burden of this invasive organism. This should be accompanied by expeditious initiation of amphotericin B along with supportive therapy. Here we present five cases of rhino-orbital mucormycosis in patients with COVID-19, all of whom presented with orbital and facial swelling (three had symptoms of impending blindness) under the backdrop of COVID-19 symptoms in the form of intermittent fever and slight dyspnea. Our treatment strategy comprised an expeditious use of early surgical intervention and amphotericin B along with the control of cytokine storm and hyperglycemia. This treatment strategy eventually resulted in an improved clinical outcome.
毛霉病是一种侵袭性真菌感染，可发生于有或无基础疾病的患者。在当前的2019冠状病毒病（COVID-19）大流行期间，越来越多的报告称，一些患有糖尿病和高血压等基础疾病的COVID-19患者出现了细菌和真菌合并感染，毛霉病就是其中之一。对这种可怕的真菌感染的治疗需要早期及时的手术干预，以彻底清除感染组织和坏死物质，减轻这种侵袭性生物体的组织负担。同时应迅速开始使用两性霉素B并辅以支持治疗。在此，我们报告5例COVID-19患者的鼻眶毛霉病，所有患者在间歇性发热和轻微呼吸困难等COVID-19症状的背景下，均出现眼眶和面部肿胀（3例有即将失明的症状）。我们的治疗策略包括迅速进行早期手术干预和使用两性霉素B，同时控制细胞因子风暴和高血糖。这一治疗策略最终改善了临床结局。
