Krishna Vidya, Bansal Nitin, Morjaria Jaymin, Kaul Sundeep
Institute of Infectious Diseases, Apollo Hospitals, Chennai 600006, India.
Division of Infectious Diseases, Rajiv Gandhi Cancer Institute, New Delhi 110085, India.
J Fungi (Basel). 2022 Jul 5;8(7):711. doi: 10.3390/jof8070711.
COVID-19-associated mucormycosis (CAM) emerged as an epidemic in certain parts of the world amidst the global COVID-19 pandemic. While rhino-orbital mucormycosis was well reported during the pandemic, in the absence of routine diagnostic facilities including lower airway sampling, pulmonary mucormycosis was probably under-recognized. In this review, we have focused on the epidemiology and management of COVID-19-associated pulmonary mucormycosis (CAPM). CAPM is a deadly disease and mortality can be as high as 80% in the absence of early clinical suspicion and treatment. While histopathological examination of tissue for angio-invasion and cultures have remained gold standard for diagnosis, there is an increasing interest in molecular and serological methods to facilitate diagnosis in critically ill patients and often, immune-suppressed hosts who cannot readily undergo invasive sampling. Combined medical and surgical treatment offers more promise than standalone medical therapy. Maintaining adequate glycemic control and prudent use of steroids which can be a double-edged sword in COVID-19 patients are the key preventative measures. We would like to emphasize the urgent need for the development and validation of reliable biomarkers and molecular diagnostics to facilitate early diagnosis.
在全球新冠疫情期间，新型冠状病毒肺炎相关毛霉病（CAM）在世界某些地区成为一种流行病。虽然在疫情期间鼻眶毛霉病有大量报道，但由于缺乏包括下呼吸道采样在内的常规诊断设施，肺毛霉病可能未得到充分认识。在本综述中，我们重点关注了新型冠状病毒肺炎相关肺毛霉病（CAPM）的流行病学和管理。CAPM是一种致命疾病，在缺乏早期临床怀疑和治疗的情况下，死亡率可高达80%。虽然组织的血管侵袭组织病理学检查和培养仍然是诊断的金标准，但人们对分子和血清学方法的兴趣日益增加，以促进对重症患者以及通常无法轻易接受侵入性采样的免疫抑制宿主的诊断。联合药物和手术治疗比单独的药物治疗更有前景。维持血糖的充分控制以及谨慎使用在新冠患者中可能是双刃剑的类固醇是关键预防措施。我们强调迫切需要开发和验证可靠的生物标志物和分子诊断方法以促进早期诊断。
