Dual Invasive Pulmonary Mycosis in a Post Covid-19 Patient: An Autopsy Diagnosis
DOI:
https://doi.org/10.21276/apalm.3294Keywords:
Autopsy, Invasive Fungal Infections, Pulmonary Aspergillosis – Invasive, MucormycosisAbstract
Patients suffering from Covid19 associated lower respiratory tract infection are most often in an immunocompromised state and are indeed vulnerable to a host of bacterial and fungal infections. Among the fungi, common invaders include candidiasis, aspergillosis and mucormycosis. Aspergillosis is a relatively common fungal infection which has been widely reported to occur in patients suffering from or recently recovered Covid19 infection. The invasive form of this fungus, is, however, less commonly reported in literature. Invasive pulmonary mucormycosis is a relatively uncommon pulmonary fungal disease. Its early diagnosis is essential but difficult as it lacks an effective treatment protocol. Commonly affecting a primarily immunocompromised host, the diagnosis of both infecting fungi primarily rests upon detection of their hyphae and/or spores in the lung and vascular tissue. This report describes presence of invasive pulmonary mucor and aspergillosis detected at autopsy in a post covid 19 patient, who presented with a naso-orbital swelling and had a rather silent clinical course followed by sudden onset of a single episode of massive hemoptysis resulting in his death.
References
Rai DK, Satish K. Dual invasive fungal infection by Aspergillus and Mucor in COVID-19 patient: a rare case report with literature review. Arch Med Health Sci. 2021;9(2):278–82.
Kousha M, Tadi R, Soubani AO. Pulmonary aspergillosis: a clinical review. Eur Respir Rev. 2011;20:156–74.
Rankin N. Disseminated aspergillosis and moniliasis associated with agranulocytosis and antibiotic therapy. Br Med J. 1953;1(4816):918–9.
Mekki SO, Hassan AA, Falemban A, Alkotani N, Alsharif SM, Haron A, et al. Pulmonary mucormycosis: A case report of a rare infection with potential diagnostic problems. Case Rep Pathol. 2020 Jan 9;2020:1–4.
Gupta KL, Khullar D, Behera D, Radotra BD, Sakhuja V. Pulmonary mucormycosis presenting as fatal massive haemoptysis in a renal transplant recipient. Nephrol Dial Transplant. 1998;13.
Seifert S, Wiley J, Kirkham J, Lena S, Schiers K. Pulmonary mucormycosis with extensive bronchial necrosis and bronchomediastinal fistula: A case report and review. Respir Med Case Rep. 2020 Jan 1;30.
Mirsadraee M, Sadrizadeh A, Md MM, Md TM, Md AD, Md SN, et al. Mucormycosis of the lung, a rare cause for lung cavitations. Iran J Otorhinolaryngol. 2006;18.
Misra P, Roy P, Dutta V, Saha TK. Fatal massive hemoptysis: An autopsy study. Med J Armed Forces India. 2015 Jul 1;71(Suppl):S234–6.
Potenza L, Vallerini D, Barozzi P, Riva G, Forghieri F, Zanetti E, et al. Mucorales-specific T cells emerge in the course of invasive mucormycosis and may be used as a surrogate diagnostic marker in high-risk patients. Blood. 2011 Nov 17;118(20):5416–9.
Pasero D, Sanna S, Liperi C, Piredda D, Branca G, Casadio L, et al. A challenging complication following SARS-CoV-2 infection: a case of pulmonary mucormycosis. Infection. 2021 Oct 1;49(5):1055–60.
Morton CO, Griffiths JS, Loeffler J, Orr S, White PL. Defective antifungal immunity in patients with COVID-19. Front Immunol. 2022;13.
Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE. Pulmonary mucormycosis: Results of medical and surgical therapy. Ann Thorac Surg. 1994;57:1044–50.
Hou X, Zhang H, Kou L, Lv W, Lu J, Li J. Clinical features and diagnosis of chronic pulmonary aspergillosis in Chinese patients. Medicine (United States). 2017 Oct 1;96(42).
Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B, 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:e405–21.
Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin Infect Dis. 2005 Sep 1;41(5):634–53.
Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: Systematic review of the literature. Clin Infect Dis. 2001;32(3):358–366.
Khan N, Gutierrez CG, Martinez DV, Proud KC. A case report of COVID-19 associated pulmonary mucormycosis. Archive of Clinical Cases. 2020 Dec;07(03):46–51.
Johnson AK, Ghazarian Z, Cendrowski KD, Persichino JG. Pulmonary aspergillosis and mucormycosis in a patient with COVID-19. Med Mycol Case Rep. 2021 Jun 1;32:64–7.
Bellanger A, Navellou J, Lepiller Q, Brion A, Brunel A, Millon L, et al. Mixed mold infection with Aspergillus fumigatus and Rhizopus microsporus in a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) patient. Infect Dis Now. 2021;51:633–5.
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