Abhirami B, Kumar Prabhat, Mishra Dharmendra Kumar, Yadav Satyendra Prasad
Department of Dermatology, Venereology, Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Indian J Dermatol. 2022 Mar-Apr;67(2):206. doi: 10.4103/ijd.ijd_781_21.
Mucormycosis is an angioinvasive mucorales fungal infection. Cutaneous type formed 10.5% of cases in India in precovid-19 era. Glucocorticoid-induced immunosuppression and hyperglycemia, reusable oxygen humidifiers in COVID-19 therapy, and preexisting uncontrolled diabetes mellitus contribute to post-COVID-19 mucormycosis. However, for post-COVID-19 cutaneous mucormycosis, sufficient data is not available.
To study factors related to post-COVID-19 cutaneous mucormycosis.
Clinical and investigation details of six patients admitted in tertiary center with post-COVID-19 cutaneous mucormycosis.
Among six patients, three were males and three females; all in 45-60 years age group from districts under tertiary center. Site of eschar was face (four) and lips (two). All six were positive for COVID-19 10-12 days prior to admission for mucormycosis. All had intravenous steroids and supportive humidified oxygen therapy for minimum 1 week under COVID-19 treatment. They presented to emergency with ophthalmic/ENT complaints; subsequently, they developed cutaneous manifestations within 2-3 days. All six had diabetes mellitus, with above 400 mg/dL sugar levels at admission.
This study's findings correlated with various studies across the country and elsewhere. Preexisting diabetes mellitus and steroid therapy for COVID-19 increase the risk of mucormycosis. Caution for early diagnosis, maintaining blood glucose levels, and judicious use of steroids for treatment of COVID-19 are indicated.
毛霉病是一种血管侵袭性毛霉目真菌感染。在新冠疫情前的印度,皮肤型毛霉病占病例的10.5%。糖皮质激素诱导的免疫抑制和高血糖、新冠治疗中使用的可重复使用的氧气加湿器以及先前未得到控制的糖尿病都与新冠后毛霉病有关。然而,关于新冠后皮肤毛霉病,尚无充分的数据。
研究与新冠后皮肤毛霉病相关的因素。
对一家三级中心收治的6例新冠后皮肤毛霉病患者的临床和检查细节进行研究。
6例患者中,3例男性,3例女性;均来自三级中心所在地区,年龄在45至60岁之间。焦痂部位为面部(4例)和嘴唇(2例)。所有6例患者在因毛霉病入院前10至12天新冠病毒检测均呈阳性。在新冠治疗期间,所有患者均接受了至少1周的静脉类固醇和支持性湿化氧疗。他们因眼科/耳鼻喉科症状到急诊科就诊;随后,在2至3天内出现了皮肤表现。所有6例患者均患有糖尿病,入院时血糖水平高于400mg/dL。
本研究结果与全国及其他地区的多项研究相关。先前存在的糖尿病和新冠治疗中使用类固醇会增加毛霉病的风险。提示需注意早期诊断、维持血糖水平以及谨慎使用类固醇治疗新冠。