No abstract

Background Mucormycosis is a serious fungal infection associated with uncontrolled diabetes and immunocompromised patients. This angioinvasive infection emerged as a post‐covid complication worldwide especially in developing countries. Due to the common socio‐demographic status of South Asian countries, we expected a surge in mucormycosis cases in Pakistan. This study aims to observe the frequency and survival of Covid associated mucormycosis patients at tertiary care hospitals in Pakistan during the third wave of Covid‐19 in 2021. Materials and Methods In this retrospective study, we collected the data of clinically and histopathologically confirmed cases of rhino‐occipito‐cerebral mucormycosis from three tertiary care hospitals of Lahore. These cases were analysed for history of Covid‐19 and other associated comorbidities using SPSS28. History of steroid medication was also taken. Data were retrieved from May to July 2021 after the approval from the ethical review board. Results Out of the total 43 reported patients of mucormycosis in the set time frame only 22 cases had a history of Covid‐19. The mean age was 50 ± 13.27 years with slight male predilection (60%). Diabetes mellitus was the most common comorbidity (88.4%) and all the patients with covid associated mucormycosis (CAM) had taken corticosteroid regimen for covid management ( p < 0.0001). The survival of the patient was not significantly different between CAM and non‐CAM patients of Mucormycosis ( p = 0.747). Conclusion Covid‐19 and mucormycosis make a lethal duo against the weakened health system of Pakistan. This problem can be prevented by avoiding nonjudicial use of corticosteroids and proper diabetes control program following Covid‐19 infection. Furthermore, large‐scale epidemiological studies should be carried out to evaluate the true burden of Mucormycosis in the population.

Of late, fungal infections are increasingly being recognized in diabetic patients. Here we present a case of polymicrobial fungal empyema due to Trichosporon species and Fusarium species developed after community-acquired pneumonia in a diabetic patient. Trichosporon species are basidiomycetous yeast and Fusarium species are soil saprophytes with a worldwide distribution. Fungal empyema cases are rare and are mostly caused by Aspergillus and Candida species. Polymicrobial fungal empyema with Trichosporon species and Fusarium species has not been reported previously. Our patient was successfully treated with antifungal therapy. This case highlights that fungal empyema should be considered in diabetic patients especially if they are not responding to antibiotics.

Hepatitis, a condition of liver’s inflammation that can be self-limiting or, in certain chances, it may lead to liver cancer, fibrosis or cirrhosis. Hepatitis viruses mainly cause hepatitis in the world. People with hepatitis C have predominant chances to develop diabetes as HCV virus participates in causing type 2 diabetes. HCV virus causes pathogenesis in two ways: it either directly destroys the β cells of pancreas or contributes to the specific autoimmunity of β cells. The present cross sectional study was done in Wazirabad Tahsil of Gujranwala District to analyze the percentage of patients suffering from hepatitis C who had the risk of diabetes mellitus. For this research work, demographic information and data about any other medical history were collected by using a questionnaire. Blood samples were collected from hospital and real time PCR was performed to measure the viral load and blood sugar was measured by using glucometer. Data were then analyzed by using statistically designed software. A total of 29.33% patients, having hepatitis C, were found to be diabetic in Tehsil Wazirabad. 14.70% male and 38.59% female patients having hepatitis C were diabetic. From results shown that the patients of hepatitis C are at higher risk to develop diabetes, therefore; it is supposed that persons having hepatitis C should regularly visit doctors for routine check-up of diabetes and change their life style to reduce the risk of developing diabetes.