Cutaneous Mucormycosis Co-infection in a Patient with COVID-19

Mucormycosis is a life-threatening fungal infection usually seen in patients who are immunocompromised; however, to date, it has been rarely described in patients with COVID-19, although more recently, reports from India have described an increased incidence of these infections. This report describ...

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Main Authors: Raham Rahgoshai, Peter Goldberg, Rayhaneh Rahgoshai, Shadi Zain
Format: Article
Language:English
Published: European Medical Journal 2022-10-01
Series:European Medical Journal
Online Access:https://www.emjreviews.com/respiratory/article/cutaneous-mucormycosis-co-infection-in-a-patient-with-covid-19/
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author Raham Rahgoshai
Peter Goldberg
Rayhaneh Rahgoshai
Shadi Zain
author_facet Raham Rahgoshai
Peter Goldberg
Rayhaneh Rahgoshai
Shadi Zain
author_sort Raham Rahgoshai
collection DOAJ
description Mucormycosis is a life-threatening fungal infection usually seen in patients who are immunocompromised; however, to date, it has been rarely described in patients with COVID-19, although more recently, reports from India have described an increased incidence of these infections. This report describes a patient with COVID-19 who developed a fatal dermatologic mucormycosis infection. The patient, whose history included therapy for diffuse large B-cell lymphoma, had an incidental positive screening test for COVID-19 in February 2021 after exposure to a family member who had tested positive. They then presented to the emergency room a few weeks later exhibiting progressive dyspnoea and fever. A CT scan of the chest revealed ground glass opacities. They were intubated approximately 2 weeks later and their course was complicated by renal failure, for which continuous renal replacement therapy was started, and by refractory hypoxaemic and hypercapnic respiratory failure in which they were placed on venovenous extracorporeal membrane oxygenation. During their course in the intensive care unit (ICU), they developed a right thigh haematoma, thought to be related to the previous insertion of a femoral arterial pressure monitoring catheter. Several days before the patient’s death, the wound noted to be covered by a brown-black eschar was cultured on April 30 and returned positive for Rhizopus oryzae and Staphylococcus epidermidis on May 5. The patient was immediately started on liposomal amphotericin and posaconazole and taken urgently taken to the operating room for a radical debridement. Unfortunately, their post-operative course was characterised by fulminant haemodynamic collapse and multiple system organ failure, from which the patient died.
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spelling doaj-art-3769aecd0b6740f18b485b2803b855242025-01-23T10:56:09ZengEuropean Medical JournalEuropean Medical Journal2397-67642022-10-0110.33590/emj/10098860Cutaneous Mucormycosis Co-infection in a Patient with COVID-19Raham Rahgoshai0Peter Goldberg1Rayhaneh Rahgoshai2Shadi Zain3McGill University Health Centre, Montreal, CanadaMcGill University Health Centre, Montreal, CanadaMcGill University Health Centre, Montreal, CanadaMcGill University Health Centre, Montreal, Canada Mucormycosis is a life-threatening fungal infection usually seen in patients who are immunocompromised; however, to date, it has been rarely described in patients with COVID-19, although more recently, reports from India have described an increased incidence of these infections. This report describes a patient with COVID-19 who developed a fatal dermatologic mucormycosis infection. The patient, whose history included therapy for diffuse large B-cell lymphoma, had an incidental positive screening test for COVID-19 in February 2021 after exposure to a family member who had tested positive. They then presented to the emergency room a few weeks later exhibiting progressive dyspnoea and fever. A CT scan of the chest revealed ground glass opacities. They were intubated approximately 2 weeks later and their course was complicated by renal failure, for which continuous renal replacement therapy was started, and by refractory hypoxaemic and hypercapnic respiratory failure in which they were placed on venovenous extracorporeal membrane oxygenation. During their course in the intensive care unit (ICU), they developed a right thigh haematoma, thought to be related to the previous insertion of a femoral arterial pressure monitoring catheter. Several days before the patient’s death, the wound noted to be covered by a brown-black eschar was cultured on April 30 and returned positive for Rhizopus oryzae and Staphylococcus epidermidis on May 5. The patient was immediately started on liposomal amphotericin and posaconazole and taken urgently taken to the operating room for a radical debridement. Unfortunately, their post-operative course was characterised by fulminant haemodynamic collapse and multiple system organ failure, from which the patient died.https://www.emjreviews.com/respiratory/article/cutaneous-mucormycosis-co-infection-in-a-patient-with-covid-19/
spellingShingle Raham Rahgoshai
Peter Goldberg
Rayhaneh Rahgoshai
Shadi Zain
Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
European Medical Journal
title Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
title_full Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
title_fullStr Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
title_full_unstemmed Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
title_short Cutaneous Mucormycosis Co-infection in a Patient with COVID-19
title_sort cutaneous mucormycosis co infection in a patient with covid 19
url https://www.emjreviews.com/respiratory/article/cutaneous-mucormycosis-co-infection-in-a-patient-with-covid-19/
work_keys_str_mv AT rahamrahgoshai cutaneousmucormycosiscoinfectioninapatientwithcovid19
AT petergoldberg cutaneousmucormycosiscoinfectioninapatientwithcovid19
AT rayhanehrahgoshai cutaneousmucormycosiscoinfectioninapatientwithcovid19
AT shadizain cutaneousmucormycosiscoinfectioninapatientwithcovid19