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伊朗一名新冠肺炎糖尿病患者由[未提及具体病因]引起的鼻眶毛霉菌病的首例报告及近期文献综述。

First report of rhino-orbital mucormycosis caused by in a diabetic patient with COVID-19 in Iran and review of recent literature.

作者信息

Taghizadeh Armaki Mojtaba, Jafarzadeh Jalal, Mahdavi Omran Saeid, Bayani Masoumeh, Tavassoli Ali, Faeli Leila, Nosratabadi Mohsen, Yaalimadad Sanaz, Nikoueian Bahador, Haghani Iman, Moazeni Maryam, Shokohi Tahereh, Taghi Hedayati Mohammad, Abastabar Mahdi

机构信息

Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

出版信息

Curr Med Mycol. 2022 Jun;8(2):49-54. doi: 10.18502/cmm.8.2.10333.

Abstract

BACKGROUND AND PURPOSE

Invasive mucormycosis is a rare mycosis that affects most cases of uncontrolled diabetes and has a high mortality rate. Patients with COVID-19 are at high risk of developing invasive mucormycosis due to the consumption of anti-inflammatory drugs such as corticosteroids and dexamethasone. species followed by spp. and spp. are the main common etiological agents of rhino-orbital mucormycosis. Therefore, this study aimed to present a case of mucormycosis due to in a diabetic patient with COVID-19 for the first time in Iran.

CASE REPORT

A 73-year-old diabetic female was referred to Ayatollah Rouhani Hospital in Babol, Iran, with a confirmed COVID-19 diagnosis, based on positive RT-PCR and computed tomography of the lungs. She has received methylprednisolone due to severe lung complications. Nasal involvement and left orbital swelling were observed 20 days after the hospitalization. By sinus endoscopic surgery, debridement was done and histopathology indicated wide hyphae (without septa). The sequenced PCR products displayed . In the antifungal susceptibility test, amphotericin B showed good activity against and the patient survived with timely treatment.

CONCLUSION

This is the first case report of rhino-orbital mucormycosis due to in COVID-19 patient; therefore, can be considered one of the etiological factors of rhino-orbital mucormycosis in COVID-19 cases.

摘要

背景与目的

侵袭性毛霉病是一种罕见的真菌病,多见于血糖控制不佳的糖尿病患者,死亡率很高。新型冠状病毒肺炎(COVID-19)患者因使用皮质类固醇和地塞米松等抗炎药物,发生侵袭性毛霉病的风险很高。根霉属其次是毛霉属和犁头霉属是鼻眶毛霉病的主要常见病原体。因此,本研究旨在首次报告伊朗一名COVID-19糖尿病患者发生的由根霉引起的毛霉病病例。

病例报告

一名73岁的糖尿病女性因RT-PCR检测呈阳性及肺部计算机断层扫描确诊为COVID-19,被转诊至伊朗巴博勒的阿亚图拉·鲁哈尼医院。由于严重的肺部并发症,她接受了甲泼尼龙治疗。住院20天后观察到鼻腔受累和左眼眶肿胀。通过鼻窦内镜手术进行清创,组织病理学显示为粗大菌丝(无隔膜)。PCR产物测序显示为根霉。在抗真菌药敏试验中,两性霉素B对根霉显示出良好的活性,患者经及时治疗后存活。

结论

这是首例关于COVID-19患者发生根霉所致鼻眶毛霉病的病例报告;因此,根霉可被视为COVID-19病例中鼻眶毛霉病的病因之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c96c/9825793/3e7540f02925/CMM-8-49-g001.jpg

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