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Polymicrobial infection including Mucormycosis in a patient with COVID-19: A case report
Natalia Ramos-Ospina1, Juanita María Parra-Villamil1, Luis Gabriel Parra-Lara2
1Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia.
Background:
Mucormycosis associated with COVID-19 has been linked with higher mortality. Patients with risk factors such as immunosuppression, especially transplant recipients, are at heightened risk for these fungal related complications and poor clinical outcomes. Species like Rhizopus, Mucor, Rhizomucor and Lichtheimia are characterized by tissue necrosis, requiring prompt diagnosis and treatment to mitigate associated morbidity.
Case Presentation:
A 54-year-old female, kidney transplant recipient, presented with respiratory failure due to SARS-CoV-2. During hospitalization, she developed rapidly progressing facial lesions involving maxillary tissue necrosis. Multiple surgeries were performed, and various microorganisms, including Rhizopus oryzae, were isolated. Effective infection control was achieved through surgical management and broad-spectrum antibiotic therapy (ceftolozane/tazobactam and amphotericin B), resulting in lesion improvement without relapse. Patient is alive after 3 years of follow-up with good performance status and renal function.
Conclusion – Key Takeaways:
An early diagnosis and multidisciplinary management of mucormycosis, particularly in immunosuppressed patients within the context of SARS-CoV-2 infection, could improve clinical outcomes.
Insights
COVID-19 associated mucormycosis is deadly, especially for transplant recipients. Early diagnosis and multidisciplinary care improve outcomes for these high-risk fungal infections.
Area of Science:
- Mycology
- Infectious Diseases
- Transplantation
Background:
- COVID-19 associated mucormycosis presents a significant mortality risk.
- Immunosuppressed patients, particularly transplant recipients, face heightened risks of fungal complications.
- Fungal species like Rhizopus cause tissue necrosis, necessitating prompt diagnosis and treatment.
Observation:
- A kidney transplant recipient with SARS-CoV-2 developed rapidly progressing facial necrosis.
- Rhizopus oryzae was identified, and the patient underwent multiple surgical interventions.
- Treatment included broad-spectrum antibiotics and antifungal therapy.
Findings:
- Surgical management and combination therapy led to lesion improvement.
- The patient survived and maintained good health status three years post-treatment.
- No relapse of the fungal infection was observed.
Implications:
- Early diagnosis and multidisciplinary management are crucial for improving outcomes in COVID-19 patients with mucormycosis.
- Aggressive treatment strategies, including surgery and targeted antimicrobial therapy, are vital.
- This case highlights the importance of vigilance for opportunistic fungal infections in immunocompromised individuals during viral pandemics.
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