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Fonsecaea associated cerebral phaeohyphomycosis in a post-COVID-19 patient: A first case report
Simin Laiq1, Mubarak Al Yaqoobi2, Maimuna Al Saadi1
1Department of Histopathology, Directorate General of Khoula Hospital, Muscat, Oman.
Abstract:
Phaeohyphomycosis, previously known as chromoblastomycosis, is a chronic mycosis, usually affecting the skin. It is caused by dematiaceous fungi, which are a group of fungi that produce melanin in their cell walls. Cerebral phaeohyphomycosis occurs as a part of invasive presentation of the fungi, which usually affects immunocompromised patients, but may affect immunocompetent individuals as well. Cerebral infection in phaeohyphomycosis is associated with a poor prognosis regardless of the immune status of the patient. COVID-19 SARS-CoV-2 infection and/or medications used for its treatment may compromise the immune system, including in the post-COVID-19 period, resulting in invasive fungal infections, which have frequently been reported recently during the COVID-19 pandemic. We report a case of Fonsecaea associated cerebral phaeohyphomycosis in a recently diagnosed diabetic Omani lady, who presented to our hospital 6 weeks after recovery and discharge from hospitalization for moderate COVID-19 pneumonia.
Insights
Cerebral phaeohyphomycosis, a fungal brain infection, can occur after COVID-19. This case highlights a rare Fonsecaea infection in a diabetic patient post-COVID-19, emphasizing poor prognosis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Neurology
Background:
- Phaeohyphomycosis is a chronic fungal infection caused by dematiaceous fungi, typically affecting the skin.
- Cerebral phaeohyphomycosis, a rare invasive form, affects the brain and carries a poor prognosis, even in immunocompetent individuals.
- The COVID-19 pandemic has seen an increase in invasive fungal infections, potentially due to viral effects or treatments on the immune system.
Observation:
- A case of cerebral phaeohyphomycosis caused by Fonsecaea was observed.
- The patient was a recently diagnosed diabetic woman from Oman.
- The patient presented six weeks after recovering from moderate COVID-19 pneumonia.
Findings:
- This report details a rare instance of Fonsecaea-associated cerebral phaeohyphomycosis.
- The infection occurred in a patient with recent COVID-19 and diabetes mellitus.
- The case underscores the potential for invasive fungal infections in the post-COVID-19 period.
Implications:
- This case highlights the importance of considering invasive fungal infections, like cerebral phaeohyphomycosis, in patients with recent COVID-19, especially those with comorbidities.
- Early diagnosis and management are crucial for improving outcomes in cerebral phaeohyphomycosis.
- Further research is needed to understand the link between COVID-19, immunosuppression, and invasive fungal infections.
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