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A case series of post COVID-19 mucormycosis-a neurological prospective
1Neurology Department, Faculty of Medicine, Ain Shams University, 38 Abbasia, PO 11591, Cairo, Egypt.
Background:
Direct neurological manifestations of coronavirus disease whether peripheral or central are reported worldwide. Yet, along the 3rd wave of the pandemic especially in India, an associated angioinvasive opportunistic infection with mucormycosis in COVID-19 cases is emerging.
Case Presentation:
The current case series which represents 4 patients with mucormycosis post COVID-19 is one of a few if not the first case series that discusses post COVID-19 mucormycosis from a neurological prospective in a tertiary hospital in Egypt.All cases but one presented with total ophthalmoplegia, and only one was diagnosed as a cavernous sinus thrombosis; meanwhile, orbital cellulitis and orbital apex syndrome were responsible of ophthalmoplegia in two cases.Mortality reached 25%, and the case that died suffered cutaneous as well as rhino-cerebral type with a delayed presentation to hospital.
Conclusion:
A rare but fatal fungal infection is ought to be nowadays kept in mind in COVID-19 active cases as well as in recovered COVID-19 patients, especially those who have comorbid medical conditions as uncontrolled diabetes and who were treated with large doses of corticosteroids.
Insights
Mucormycosis, a dangerous fungal infection, is increasingly seen in COVID-19 patients, particularly those with diabetes and corticosteroid use. Neurological complications like ophthalmoplegia are significant, with a notable mortality rate.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Neurological complications of COVID-19 are globally documented.
- An emerging concern is angioinvasive opportunistic mucormycosis in COVID-19 patients, particularly noted during the third wave in India.
Observation:
- This case series details four patients with mucormycosis following COVID-19, focusing on neurological sequelae.
- Ophthalmoplegia was a common presentation, with diagnoses including cavernous sinus thrombosis, orbital cellulitis, and orbital apex syndrome.
Findings:
- The study highlights a 25% mortality rate among the observed cases.
- The fatal case involved cutaneous and rhino-cerebral mucormycosis with delayed hospital presentation.
Implications:
- Mucormycosis is a rare but potentially fatal fungal infection that requires consideration in both active and recovered COVID-19 cases.
- Patients with comorbid conditions like uncontrolled diabetes and those treated with high-dose corticosteroids are at increased risk.
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