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一名非霍奇金淋巴瘤患者感染新冠病毒后发生鼻眶毛霉菌病

Rhino-Orbital Mucormycosis After COVID-19 Infection in a Patient With Non-Hodgkin's Lymphoma.

作者信息

Hannan Tabiha B, Paul Shrebash, Barai Lovely, Alam Md Rafiqul, Chowdhury Fazle Rabbi

机构信息

Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.

Microbiology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, BGD.

出版信息

Cureus. 2022 Feb 22;14(2):e22485. doi: 10.7759/cureus.22485. eCollection 2022 Feb.

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be succeeded by a spectrum of complications, including invasive fungal infections (IFIs). Here, we describe a case of rhino-orbital mucormycosis in a recovered coronavirus disease-19 (COVID-19) patient with underlying non-Hodgkin's lymphoma (NHL). Our patient was normotensive, non-diabetic, presenting with multiple non-healing ulcers on different parts of the body. She received high-dose glucocorticoids and antibiotics during her severe COVID-19 illness. Three weeks following COVID-19 detection, she developed progressive rhino-orbital lesion with profuse pus formation, along with pain and redness of the left eye. Histopathology from the lesion revealed mucormycosis. She was treated with Amphotericin B. Unfortunately, the patient died after the first cycle of chemotherapy for NHL. Due to the high chance of mortality, timely clinical suspicion along with microbiological diagnosis is necessary for the early detection of infection. Strong policymaking should also be implicated to revisit the cost effectiveness of available treatments to reduce case fatality.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)可能会引发一系列并发症,包括侵袭性真菌感染(IFI)。在此,我们描述了一例康复的冠状病毒病19(COVID-19)患者并发鼻眶毛霉菌病的病例,该患者患有非霍奇金淋巴瘤(NHL)。我们的患者血压正常,无糖尿病史,身体不同部位出现多处不愈合溃疡。在她患重症COVID-19期间接受了大剂量糖皮质激素和抗生素治疗。COVID-19检测三周后,她出现进行性鼻眶病变,伴有大量脓液形成,同时左眼疼痛、发红。病变组织病理学检查显示为毛霉菌病。她接受了两性霉素B治疗。不幸的是,该患者在接受NHL第一轮化疗后死亡。鉴于死亡率较高,及时的临床怀疑以及微生物学诊断对于早期发现感染至关重要。还应制定强有力的政策,重新审视现有治疗方法的成本效益,以降低病死率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e70a/8944171/1159e2bf7ef2/cureus-0014-00000022485-i01.jpg

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