Panwar Parshika, Gupta Anish, Kumar Amit, Gupta Bhavna, Navriya Shiv C
Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Indian J Crit Care Med. 2021 Nov;25(11):1314-1317. doi: 10.5005/jp-journals-10071-24025.
Infectious diseases with the coronavirus disease-2019 (COVID-19) can be linked to various microbial and fungal coinfections. Mucormycosis is an invasive opportunistic infection that enters as inhalation of fungal spores through the nose or paranasal sinuses in diabetic and immunocompromised patients. We present our experience of managing seven cases of recent COVID-19 infection with uncontrolled diabetes who developed rhino-orbital mucormycosis. All patients were diagnosed by clinical examination and imaging and managed by emergency surgical debridement and liposomal amphotericin-B. A lethal triad of impaired immunity due to COVID-19 infection, state of hyperglycemia, increased use of steroids, or rampant broad-spectrum antimicrobials works as fertile soil and may assist in the growth or alleviation of a fungal infection. Healthcare professionals must be aware of the potential of secondary invasive fungal infections in diabetic patients with moderate to severe category of COVID-19 infectious disease, especially on steroid therapy.
Panwar P, Gupta A, Kumar A, Gupta B, Navriya SC. Mucormycosis in COVID Diabetic Patients: A Horrifying Triad! Indian J Crit Care Med 2021;25(11):1314-1317.
2019冠状病毒病(COVID-19)相关的传染病可能与多种微生物和真菌合并感染有关。毛霉菌病是一种侵袭性机会性感染,在糖尿病和免疫功能低下的患者中,通过鼻腔或鼻窦吸入真菌孢子而发病。我们介绍了我们对7例近期COVID-19感染且糖尿病控制不佳并发生鼻眶毛霉菌病患者的治疗经验。所有患者均通过临床检查和影像学检查确诊,并接受了急诊手术清创和脂质体两性霉素B治疗。由COVID-19感染导致的免疫受损、高血糖状态、类固醇使用增加或大量使用广谱抗菌药物这一致命三联征,就像肥沃的土壤,可能有助于真菌感染的滋生或加重。医疗保健专业人员必须意识到,中度至重度COVID-19传染病的糖尿病患者,尤其是正在接受类固醇治疗的患者,有发生继发性侵袭性真菌感染的可能性。
潘瓦尔P,古普塔A,库马尔A,古普塔B,纳夫里亚SC。COVID糖尿病患者的毛霉菌病:一个可怕的三联征!《印度重症监护医学杂志》2021年;25(11):1314 - 1317。