Multidisciplinary approach in the management of acute invasive mucormycosis post-COVID-19: Clinical case reports
DOI:
https://doi.org/10.33448/rsd-v13i12.47176Keywords:
Mucormycosis; COVID-19; Invasive Fungal Infections.Abstract
Mucormycosis is a rapidly progressive fungal disease, with greater rhinocerebral, pulmonary, specific and gastrointestinal involvement. It has destructive characteristics and high morbidity and mortality, and diagnosis and management should be effective, rapid and multidisciplinary. Most human infections result from inhalation of fungal sporangiospores that have been released into the air or from direct inoculation of organisms into damaged skin or mucosa, with Mucorales fungi being the main cause. Its association with COVID-19 has shown clinical relevance and some previous reports of coexistence. The objective of this study is to report two cases of acute invasive mucormycosis in the oral cavity of a post-COVID-19 patient in a hospital in the interior of the state of São Paulo. The reports may contribute to the early identification of the disease and provide technical information to assist in the treatment of patients affected by these diseases. We aim to expand knowledge and suggest the hypothesis that new studies should be carried out with the purpose of investigating transparency between acute invasive mucormycosis post-COVID-19.
References
Aswal, G. S., Rawat, R., Dwivedi, D., Prabhakar, N., & Kumar, K. R. V. (2022). Diagnosis and management of mucormycosis in the dental clinic: A guide for oral health professionals in India. Journal of family medicine and primary care, 11(8), 4293–4298. https://doi.org/10.4103/jfmpc.jfmpc_1373_21
Biswas, D., Kotwal, A., Kakati, B., & Ahmad, S. (2015). Amphotericin B Resistant Apophysomyces elegans Causing Rhino-oculo-Cerebral Mucormycosis in an Immunocompetent Host. Journal of clinical and diagnostic research : JCDR, 9(8), DD01–DD2. https://doi.org/10.7860/JCDR/2015/13929.6272
Cornely, O. A., Alastruey-Izquierdo, A., Arenz, D., Chen, S. C. A., Dannaoui, E., Hochhegger, B., Hoenigl, M., Jensen, H. E., Lagrou, K., Lewis, R. E., Mellinghoff, S. C., Mer, M., Pana, Z. D., Seidel, D., Sheppard, D. C., Wahba, R., Akova, M., Alanio, A., Al-Hatmi, A. M. S., Arikan-Akdagli, S., … Mucormycosis ECMM MSG Global Guideline Writing Group (2019). Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. The Lancet. Infectious diseases, 19(12), e405–e421. https://doi.org/10.1016/S1473-3099(19)30312-3
Deepika, K., Goel, S., Gupta, R., & Jain, R. A. (2023). Application of Polyvinyl chloride sheet as delayed surgical obturator in maxillectomy defects secondary to mucormycosis- A case series. Journal of oral biology and craniofacial research, 13(2), 207–209. https://doi.org/10.1016/j.jobcr.2023.01.004
Espinel-Ingroff, A., Chakrabarti, A., Chowdhary, A., Cordoba, S., Dannaoui, E., Dufresne, P., Fothergill, A., Ghannoum, M., Gonzalez, G. M., Guarro, J., Kidd, S., Lass-Flörl, C., Meis, J. F., Pelaez, T., Tortorano, A. M., & Turnidge, J. (2015). Multicenter evaluation of MIC distributions for epidemiologic cutoff value definition to detect amphotericin B, posaconazole, and itraconazole resistance among the most clinically relevant species of Mucorales. Antimicrobial agents and chemotherapy, 59(3), 1745–1750. https://doi.org/10.1128/AAC.04435-14
Farmakiotis, D., & Kontoyiannis, D. P. (2016). Mucormycoses. Infectious disease clinics of North America, 30(1), 143–163. https://doi.org/10.1016/j.idc.2015.10.011
Mahalaxmi, I., Jayaramayya, K., Venkatesan, D., Subramaniam, M. D., Renu, K., Vijayakumar, P., Narayanasamy, A., Gopalakrishnan, A. V., Kumar, N. S., Sivaprakash, P., Sambasiva Rao, K. R. S., & Vellingiri, B. (2021). Mucormycosis: An opportunistic pathogen during COVID-19. Environmental research, 201, 111643. https://doi.org/10.1016/j.envres.2021.111643
Muthu, V., Rudramurthy, S. M., Chakrabarti, A., & Agarwal, R. (2021). Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World. Mycopathologia, 186(6), 739–754. https://doi.org/10.1007/s11046-021-00584-8
Nehara, H. R., Puri, I., Singhal, V., Ih, S., Bishnoi, B. R., & Sirohi, P. (2021). Rhinocerebral mucormycosis in COVID-19 patient with diabetes a deadly trio: Case series from the north-western part of India. Indian journal of medical microbiology, 39(3), 380–383. https://doi.org/10.1016/j.ijmmb.2021.05.009
Oliveira, F. M., Mota, A. C. D. O., dos Santos, A. P. F. B., Sarris, A. B., Russo, T. V. C., Rocha, M. D. G., Gaspar, G. G., Feliciano, C. S., Bollela, V. R., & Martinez, R. (2022). Mucormicose em pacientes pós covid-19: relato de três casos. The Brazilian Journal of Infectious Diseases, 26, 102487. https://doi.org/10.1016/j.bjid.2022.102487
Pal, R., Singh, B., Bhadada, S. K., Banerjee, M., Bhogal, R. S., Hage, N., & Kumar, A. (2021). COVID-19-associated mucormycosis: An updated systematic review of literature. Mycoses, 64(12), 1452–1459. https://doi.org/10.1111/myc.13338
Patel, A., Patel, K., Patel, K., Shah, K., & Chakrabarti, A. (2022). Therapeutic drug monitoring of posaconazole delayed release tablet while managing COVID-19-associated mucormycosis in a real-life setting. Mycoses, 65(3), 312–316. https://doi.org/10.1111/myc.13420
Pereira, A. S., et al. (2018). Metodologia da pesquisa científica [free e-book]. Santa Maria, RS: Ed. UAB/NTE/UFSM.
Petrikkos, G., Skiada, A., Lortholary, O., Roilides, E., Walsh, T. J., & Kontoyiannis, D. P. (2012). Epidemiology and clinical manifestations of mucormycosis. Clinical infectious diseases an official publication of the Infectious Diseases Society of America, 54 Suppl 1, S23–S34. https://doi.org/10.1093/cid/cir866.
"RECOVERY Collaborative Group, Horby, P., Lim, W. S., Emberson, J. R. et al. (2021). Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 384 (8): 693-704. DOI: 10.1056/NEJMoa2021436.
Ribeiro, A. B. O. F., Melo, M. E. A. de, Ribeiro, M. O. F. & Cardoso, A. M. (2023). Interface entre mucormicose e COVID-19. Revista Brasileira Militar de Ciências. https://doi.org/10.36414/rbmc.v9i23.150
Rodrigues, M. G., Sekiguchi, W. K., Gonçalves, S., Casal, Y. R., Frassetto, F. P., da Silva, V. T. G., Santo, M. P. D. E., & Magri, M. M. C. (2021). Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19. Autopsy & case reports, 12, e2021345. https://doi.org/10.4322/acr.2021.345
Sahu, R. K., Salem-Bekhit, M. M., Bhattacharjee, B., Almoshari, Y., Ikbal, A. M. A., Alshamrani, M., Bharali, A., Salawi, A., Widyowati, R., Alshammari, A., & Elbagory, I. (2021). Mucormycosis in Indian COVID-19 Patients: Insight into Its Patho-Genesis, Clinical Manifestation, and Management Strategies. Antibiotics (Basel, Switzerland), 10(9), 1079. https://doi.org/10.3390/antibiotics10091079
Singh, A. K., Gupta, R., Ghosh, A., & Misra, A. (2020). Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes & metabolic syndrome, 14(4), 303–310. https://doi.org/10.1016/j.dsx.2020.04.004
Skiada, A., Lass-Floerl, C., Klimko, N., Ibrahim, A., Roilides, E., & Petrikkos, G. (2018). Challenges in the diagnosis and treatment of mucormycosis. Medical mycology, 56(suppl_1), 93–101. https://doi.org/10.1093/mmy/myx101
Steinbrink, J. M., & Miceli, M. H. (2021). Mucormycosis. Infectious disease clinics of North America, 35(2), 435–452. https://doi.org/10.1016/j.idc.2021.03.009
Watanabe, A., So, M., Mitaka, H., Ishisaka, Y., Takagi, H., Inokuchi, R., Iwagami, M., & Kuno, T. (2022). Clinical Features and Mortality of COVID-19-Associated Mucormycosis: A Systematic Review and Meta-Analysis. Mycopathologia, 187(2-3), 271–289. https://doi.org/10.1007/s11046-022-00627-8
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Copyright (c) 2024 Renata Capelupe Simões Fumagalli; Igor Henrique Teixeira Fumagalli; Adriano Tadeu Dias Marangoni ; Fábio Longarini Veríssimo de Mello; Ana Laura Polizel Raniele
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