Mehta Ravindra M, Bansal Sameer, Kalpakkam Hariprasad
Department of Pulmonary and Critical Care Medicine, Apollo Hospitals, Bengaluru, Karnataka, India.
Lung India. 2022 Mar-Apr;39(2):187-190. doi: 10.4103/lungindia.lungindia_435_21.
The explosive rise in angioinvasive mucormycosis (MM) in India and other parts of the world has been described as the "epidemic following the COVID-19 pandemic," with the majority being rhino-orbital-cerebral MM. We report a case series of five COVID-19-associated pulmonary MM (CAPM) with an aggressive clinical course. Clinical and radiological clues were limited, and the initial suspicion of CAPM was the morphological appearance on bronchoscopy, which led to the diagnosis. Histopathology was consistently positive in all cases, while other microbiological and molecular tests had varying sensitivity. Most patients had a fulminant and fatal course. Also noted was dual fungal infection in 3/5 cases with coexisting multidrug resistant bacterial infection in all cases. CAPM is the hidden part of the COVID-MM epidemic and warrants a high degree of suspicion with early diagnosis and treatment.
血管侵袭性毛霉菌病（MM）在印度和世界其他地区的爆发式增长被描述为“新冠疫情后的流行病”，其中大多数为鼻眶脑型MM。我们报告了一组5例与新冠相关的肺毛霉菌病（CAPM）病例，其临床病程凶险。临床和影像学线索有限，对CAPM的最初怀疑是支气管镜检查时的形态学表现，进而得以确诊。所有病例的组织病理学检查均呈阳性，而其他微生物学和分子检测的敏感性各不相同。大多数患者病程迅猛且致命。还注意到5例中有3例存在双重真菌感染，且所有病例均合并多重耐药细菌感染。CAPM是新冠-MM疫情中隐匿的一部分，需要高度怀疑并尽早诊断和治疗。
