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A case series of mucormycosis after covid infection in two hospitals
Hélder D D Martins1, Arturo Rangel Pares2, Armando Torres Martínez3
1Post Graduation Program in Dentistry, Universidade Federal da Paraíba (UFPB), Campus I - Cidade Universitária, João Pessoa, Paraíba 58033-455, Brazil.
Abstract:
This paper aims to discuss clinical aspects of mucormycosis. This case series was conducted in two services, comprising six mucormycosis cases during COVID-19 pandemic. About gender, there are 4 (66.7%) males and 2 (33.3%) females with mean age (48.7 ± 9.4) years. All cases presented complaints of pain and swelling in oral cavity and had an aggressive clinical presentation. Five patients had diabetes and one had a nasal non-Hodgkin lymphoma. Histologically, large, branched, hyphae associated with necrotic areas were observed, confirming microscopically such as mucormycosis through PAS and GMS stains. In four cases, treatment consisted in surgical debridement associated with antifungal therapy. All patients were submitted to debridement and received antifungal treatment (amphotericin B). Five patients were followed up without clinical recurrence, but unfortunately one patient died. Diagnosis of mucormycosis should be early because it is related to high mortality. The treatment consists of surgical debridement associated with antifungal therapy.
Insights
This study highlights the aggressive nature of mucormycosis during the COVID-19 pandemic. Early diagnosis and combined surgical and antifungal treatment are crucial for managing this severe fungal infection and improving patient outcomes.
Area of Science:
- Infectious Diseases
- Mycology
- Ophthalmology
Background:
- Mucormycosis is a rare but aggressive fungal infection, particularly concerning in immunocompromised individuals.
- The COVID-19 pandemic has seen an increase in mucormycosis cases, necessitating a review of clinical presentations and management.
- Understanding the clinical nuances of mucormycosis is vital for timely diagnosis and effective treatment strategies.
Observation:
- A case series of six mucormycosis patients during the COVID-19 pandemic revealed aggressive oral cavity involvement.
- Common symptoms included pain and swelling, with comorbidities like diabetes and lymphoma noted in affected individuals.
- Histopathological examination confirmed broad, branched hyphae indicative of mucormycosis, with PAS and GMS stains aiding diagnosis.
Findings:
- Combined surgical debridement and antifungal therapy (amphotericin B) were the primary treatment modalities.
- Five out of six patients showed no recurrence after treatment, indicating treatment efficacy.
- One patient succumbed to the infection, underscoring the high mortality associated with delayed or inadequate management.
Implications:
- Early diagnosis of mucormycosis is critical due to its high mortality rate.
- Aggressive surgical intervention combined with systemic antifungal therapy offers the best chance for patient survival.
- Further research into risk factors and optimized treatment protocols for mucormycosis is warranted, especially in the context of pandemics.
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