Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19

Mariana Gonçalves Rodrigues; William Kazunori Sekiguchi; Sérgio Gonçalves; Yuri Reis Casal; Fernando Pereira Frassetto; Vinicius Trindade Gomes da Silva; Marcelo Prudente do Espírito  Santo; Marcello Mihailenko Chaves Magri

doi:10.4322/acr.2021.345

Clinical Case Report

Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19

Mariana Gonçalves Rodrigues; William Kazunori Sekiguchi; Sérgio Gonçalves; Yuri Reis Casal; Fernando Pereira Frassetto; Vinicius Trindade Gomes da Silva; Marcelo Prudente do Espírito Santo; Marcello Mihailenko Chaves Magri

http://dx.doi.org/10.4322/acr.2021.345 Autops Case Rep, vol.12, e2021345, 2022

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Abstract

Mucormycosis is a rare, sometimes severe fungal infection that has emerged as a possible complication of COVID-19. We report a case of a non-diabetic, apparently immunocompetent patient diagnosed with rhino-orbital-cerebral mucormycosis shortly after COVID-19 treatment with dexamethasone. The patient received optimized systemic antifungal therapy and extensive surgical treatment. So far, four months after the last hospital discharge, the patient has been in good general condition. This case is a dramatic reminder that beneficial corticosteroid therapy in general inevitably carries a risk of opportunistic infection, and corticosteroid therapy for COVID-19 risks orbital-rhinocerebral mucormycosis that clinicians should watch for with vigilance.

Keywords

Keywords: Immunocompetence, SARS-CoV-2, Orbit

References

1 Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. 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. Lancet Infect Dis. 2019;19(12):e405-21. http://dx.doi.org/10.1016/S1473-3099(19)30312-3. PMid:31699664.

2 Raut A, Huy NT. Rising incidence of mucormycosis in patients with COVID-19: another challenge for India amidst the second wave? Lancet Respir Med. 2021;9(8):e77. http://dx.doi.org/10.1016/S2213-2600(21)00265-4. PMid:34090607.

3 Patel A, Agarwal R, Rudramurthy SM, et al. Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis. 2021;27(9):2349-59. http://dx.doi.org/10.3201/eid2709.210934. PMid:34087089.

4 John TM, Jacob CN, Kontoyiannis DP. When uncontrolled diabetes mellitus and severe COVID-19 converge: the perfect storm for mucormycosis. J Fungi. 2021;7(4):298. http://dx.doi.org/10.3390/jof7040298. PMid:33920755.

5 Pasero D, Sanna S, Liperi C, et al. A challenging complication following SARS-CoV-2 infection: a case of pulmonary mucormycosis. Infection. 2021;49(5):1055-60. http://dx.doi.org/10.1007/s15010-020-01561-x. PMid:33331988.

Submitted date:
09/12/2021

Accepted date:
11/23/2021

Publication date:
12/20/2021

Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19

Mariana Gonçalves Rodrigues; William Kazunori Sekiguchi; Sérgio Gonçalves; Yuri Reis Casal; Fernando Pereira Frassetto; Vinicius Trindade Gomes da Silva; Marcelo Prudente do Espírito Santo; Marcello Mihailenko Chaves Magri

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