Rhino-Orbital Mucormycosis Associated With COVID-19.
Rhino-Orbital Mucormycosis Associated With COVID-19.
复制标题
与COVID-19相关的鼻-眶毛霉菌病。
DOI：
10.7759/cureus.10726
复制
发表时间：
2020-09-30
期刊：
影响因子：
--
通讯作者：
Pandey A
中科院分区：
文献类型：
--
作者：
Mehta S;Pandey A
2019冠状病毒病（COVID-19）感染可能与多种细菌和真菌合并感染有关。我们报告一例COVID-19感染患者，在治疗过程中发生鼻眶毛霉菌病。一名60岁男性患者，长期患有糖尿病，严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）逆转录酶聚合酶链反应（RT-PCR）呈阳性，入院接受治疗。他接受了肠外美罗培南和口服奥司他韦以及肠外甲基强的松龙。在入院过程中，他出现了眼眶蜂窝织炎的体征。脑部、眼眶和鼻窦的磁共振成像（MRI）显示右侧隔前、颧骨、上颌前和球后区域的软组织肿胀伴鼻窦炎。鼻活检显示广泛的无菌丝状真菌菌丝提示毛霉菌病，这是证实的培养。广泛使用类固醇/单克隆抗体/广谱抗生素可能导致既存真菌疾病的发展/加重。医生应该意识到COVID-19感染患者继发侵袭性真菌感染的可能性。
Coronavirus disease 2019 (COVID-19) infections may be associated with a wide range of bacterial and fungal co-infections. We report the case of a patient with COVID-19 infection, which, during the course of the treatment, developed rhino-orbital mucormycosis. A 60- year-old male patient, a longstanding diabetic, with a positive reverse-transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was admitted for treatment. He received parenteral meropenem and oral oseltamivir with parenteral methylprednisolone. Over the course of the admission, he developed signs of orbital cellulitis. Magnetic resonance imaging (MRI) of the brain, orbits, and paranasal sinuses, revealed soft tissue swelling in the right preseptal, malar, premaxillary and retrobulbar regions with paranasal sinusitis. A nasal biopsy revealed broad aseptate filamentous fungal hyphae suggestive of mucormycosis, which was confirmed on culture. Extensive use of steroids/monoclonal antibodies/broad-spectrum antibiotics may lead to the development/exacerbation of a preexisting fungal disease. Physicians should be aware of the possibility of secondary invasive fungal infections in patients with COVID-19 infection.