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Secondary Cutaneous Mucormycosis Post-COVID-19: Case Series from a Tertiary Center
B Abhirami1, Prabhat Kumar1, Dharmendra Kumar Mishra1
1Department of Dermatology, Venereology, Leprosy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Background:
Mucormycosis is an angioinvasive mucorales fungal infection. Cutaneous type formed 10.5% of cases in India in precovid-19 era. Glucocorticoid-induced immunosuppression and hyperglycemia, reusable oxygen humidifiers in COVID-19 therapy, and preexisting uncontrolled diabetes mellitus contribute to post-COVID-19 mucormycosis. However, for post-COVID-19 cutaneous mucormycosis, sufficient data is not available.
Aim:
To study factors related to post-COVID-19 cutaneous mucormycosis.
Methodology:
Clinical and investigation details of six patients admitted in tertiary center with post-COVID-19 cutaneous mucormycosis.
Results:
Among six patients, three were males and three females; all in 45-60 years age group from districts under tertiary center. Site of eschar was face (four) and lips (two). All six were positive for COVID-19 10-12 days prior to admission for mucormycosis. All had intravenous steroids and supportive humidified oxygen therapy for minimum 1 week under COVID-19 treatment. They presented to emergency with ophthalmic/ENT complaints; subsequently, they developed cutaneous manifestations within 2-3 days. All six had diabetes mellitus, with above 400 mg/dL sugar levels at admission.
Conclusion:
This study's findings correlated with various studies across the country and elsewhere. Preexisting diabetes mellitus and steroid therapy for COVID-19 increase the risk of mucormycosis. Caution for early diagnosis, maintaining blood glucose levels, and judicious use of steroids for treatment of COVID-19 are indicated.
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