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A case report of COVID-19 associated pulmonary mucormycosis

Nariman Khan1, Christina G Gutierrez2,3, David Villafuerte Martinez4

  • 1UT Health San Antonio, Joe R. and Terry Lozano Long School of Medicine, Department of Internal Medicine, San Antonio, Texas, USA.

Archive of Clinical Cases
|November 10, 2021
PubMed

Insights

Severe hyperglycemia and COVID-19 pneumonia complicated by a secondary fungal infection, likely Mucor, led to a fatal outcome despite aggressive treatment. This case underscores the need for early Mucor diagnosis in immunocompromised patients.

Area of Science:

  • Medicine
  • Infectious Diseases
  • Critical Care

Background:

  • Hospitalized patients with SARS-CoV-2 (COVID-19) face increased risk of secondary fungal infections.
  • Comorbidities and iatrogenic factors like corticosteroid use exacerbate this risk.
  • Zygomycetes, particularly Mucor, are emerging opportunistic pathogens in critically ill patients.

Observation:

  • A 44-year-old female with hyperglycemia and coronavirus disease 2019 (COVID-19) pneumonia presented unresponsive.
  • Despite intubation, antibiotics, remdesivir, and corticosteroids, her condition did not improve.
  • Bronchoscopy revealed necrotic lung lesions, and biopsy confirmed Zygomycetes.

Findings:

  • The patient was treated with voriconazole, micafungin, and amphotericin B for the fungal infection.
  • Maximal medical therapy was insufficient, and the patient ultimately perished.

Implications:

  • This case underscores the importance of high clinical suspicion for Mucor infections in diabetic and immunosuppressed patients.
  • A low threshold for initiating antifungal treatment is recommended for these high-risk individuals.
Keywords:
COVID-19SARS-CoV-2diabetes melitusmucormycisisremdesivirthoracic CT

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