Rashbi K Shafeedha, Ali T M Feroz, P N Deepthi, C K Saranya, Payyappilly Rajan Joseph
Department of Microbiology, Government Medical Collage Kannur, Pariyaram, Kerala, India.
Department of Electrical Engineering, Indian Institute of Technology Bombay, Mumbai, India.
Access Microbiol. 2022 Jun 6;4(6):acmi000360. doi: 10.1099/acmi.0.000360. eCollection 2022 Aug.
The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a global health problem. COVID-19 has given rise to a number of secondary bacterial or fungal infections. During the second wave of COVID-19, India experienced an epidemic of mucormycosis in COVID-19 patients. In this paper, we discuss the clinical features, investigations and management of four patients having COVID-19-associated mucormycosis (CAM), especially rhino-orbital mucormycosis (ROM) caused by and species. We also compare the cases and their risk factors with previously reported CAM cases in India. Three patients had mucormycosis after recovering from COVID-19. They were successfully treated with surgical debridement and early initiation of anti-fungal therapy with systemic amphotericin B and other supportive measures such as broad-spectrum antibiotics, insulin infusion, antihypertensives and analgesics. The remaining patient had mucormycosis during COVID-19. He was admitted in the intensive care unit due to COVID-pneumonia and was on mechanical ventilation. In spite of all supportive measures, the patient succumbed to death due to cardiogenic shock. Three out of our four patients had diabetes mellitus. All patients were treated with systemic steroid during COVID-19 treatment. Diabetes mellitus and steroid treatment are the major risk factors for CAM. Early diagnosis of this life-threatening infection along with strict control of hyperglycemia is necessary for optimal treatment and better outcomes.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019年大流行性冠状病毒病（COVID-19）是一个全球性的健康问题。COVID-19引发了一些继发性细菌或真菌感染。在COVID-19的第二波疫情期间，印度的COVID-19患者中出现了毛霉菌病流行。在本文中，我们讨论了4例COVID-19相关毛霉菌病（CAM）患者的临床特征、检查和治疗，特别是由 和 菌种引起的鼻眶毛霉菌病（ROM）。我们还将这些病例及其危险因素与印度先前报道的CAM病例进行了比较。3例患者在从COVID-19康复后患上了毛霉菌病。他们通过手术清创以及早期开始使用全身性两性霉素B进行抗真菌治疗和其他支持措施，如广谱抗生素、胰岛素输注、抗高血压药和镇痛药，成功得到了治疗。其余1例患者在COVID-19期间患上了毛霉菌病。他因COVID-肺炎入住重症监护病房并接受机械通气。尽管采取了所有支持措施，该患者仍因心源性休克死亡。我们的4例患者中有3例患有糖尿病。所有患者在COVID-19治疗期间均接受了全身性类固醇治疗。糖尿病和类固醇治疗是CAM的主要危险因素。对于这种危及生命的感染，早期诊断以及严格控制高血糖对于优化治疗和取得更好的结果是必要的。
