Faria Labeeba, Mahin Tasnova, Qader Md Abdul, Ahmed Mosaddeque, Anwar Muhammad A
Nephrology, Square Hospitals Limited, Dhaka, BGD.
Internal Medicine, Square Hospitals Limited, Dhaka, BGD.
Cureus. 2023 Jul 29;15(7):e42652. doi: 10.7759/cureus.42652. eCollection 2023 Jul.
Mucormycosis is a fulminant angioinvasive fungal infection that occurs in an immunocompromised condition, most commonly in diabetic patients. Rhino-cerebral and pulmonary infections are common but may also lead to disseminated disease associated with a high mortality rate (almost 100%). Here we report on an elderly diabetic lady presented with a headache and altered level of consciousness and peri-orbital swelling following coronavirus disease 2019 (COVID-19). Imaging studies revealed a single large space-occupying lesion in the frontal lobe extending to the left orbit and sinusitis. An excisional biopsy was taken from the middle meatus of the nasal cavity and histopathology findings were broad aseptate hyphae branching at the right angle which suggests mucormycosis. Liposomal amphotericin B was started but the patient developed acute kidney injury (AKI) and bi-cytopenia (thrombocytopenia and anemia) followed by sepsis resulting in death. Though this is a rapidly progressing disease with a high mortality rate, a strong level of suspicion and early diagnosis can save lives.
毛霉菌病是一种暴发性血管侵袭性真菌感染，发生于免疫功能低下的患者，最常见于糖尿病患者。鼻脑和肺部感染很常见，但也可能导致播散性疾病，死亡率很高（几乎100%）。在此，我们报告一位老年糖尿病女性，在感染2019冠状病毒病（COVID-19）后出现头痛、意识水平改变和眶周肿胀。影像学检查显示额叶有一个单一的大占位性病变，延伸至左侧眼眶和鼻窦炎。从鼻腔中鼻道进行了切除活检，组织病理学结果显示有宽的无隔菌丝以直角分支，提示为毛霉菌病。开始使用脂质体两性霉素B治疗，但患者出现急性肾损伤（AKI）和双血细胞减少（血小板减少和贫血），随后发生败血症导致死亡。尽管这是一种进展迅速、死亡率高的疾病，但高度怀疑和早期诊断可以挽救生命。
