COVID-19-associated mixed mold infection: A case report of aspergillosis and mucormycosis and a literature review

Benhadid-Brahmi, Yasmine; Hamane, Samia; Soyer, Benjamin; Mebazaa, Alexandre; Alanio, Alexandre; Chousterman, Benjamin; Bretagne, Stéphane; Dellière, Sarah

doi:10.1016/j.mycmed.2021.101231

Cited by 16 publications

(14 citation statements)

References 58 publications

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“…Concerning the gender distribution, our results indicated the prevalence of male patients, coinciding with the results of Sharma et al, 35 who reported the prevalence of men among 23 patients: 15 were men and 8 were women. In the present study, most of the cases have acquired fungal infection after their recovery from COVID‐19, which is consistent with the findings of Sharma et al 35 and Benhadid‐Brahmi et al, 36 who reported that mucormycosis developed after recovery from COVID‐19, as well as during the active course of the disease. Moreover, aspergillosis has been associated with COVID‐19.…”

Section: Discussionsupporting

confidence: 92%

Clinical and mycological investigations of post‐COVID‐19 acute invasive fungal sinusitis

Eldsouky

Shahat

AL-Tabbakh

et al. 2022

Laryngoscope Investig Oto

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Objectives An increased incidence of acute invasive fungal sinusitis associated with the recent COVID‐19 pandemic has been observed, which is considered a public health concern. This study aims to detect the incidence, risk factors, causative agents, clinical presentations, outcomes, and susceptibility rate of various antifungals. Methods In this cross‐sectional cohort study, a total of 30 patients showing acute invasive fungal rhinosinusitis following a COVID‐19 infection were investigated. Histopathological biopsies, culture identification, and molecular confirmation of the causative agents were conducted. The demographic data, risk factors, clinical presentations, treatment regimen and its outcomes, and efficacy of antifungals were listed and analyzed. Results A total of 30 cases with a mean age of 59.6 ± 11.9 years were included. Diabetes mellitus was the most recorded comorbidity with a rate of 86.7%, whereas most of the patients received corticosteroids. The mycological examination confirmed the existence of Mucor (Rhizopus oryzae) and Aspergillus (Aspergillus niger) in 96.7% and 3.3% of the cases, respectively. Various stages of sinonasal involvement (ethmoid, maxillary, sphenoid, and inferior turbinate) represented 100%, 83.3%, 66.7%, and 86.7% of the cases, respectively. Headache and facial pain, ophthalmoplegia, visual loss, and blindness represented 100%, 66.7%, 90%, and 53.3% of the cases, respectively. All the cases were simultaneously treated with surgical debridement and amphotericin B. Moreover, R. oryzae was susceptible to it, whereas A. niger was sensitive to voriconazole, resulting in a survival rate of 86.7% (26/30). The R. oryzae and A. niger isolates were proven to be sensitive to acetic acid, ethyl alcohol, formalin, and isopropyl alcohol. Conclusions In patients with COVID‐19, the diagnosis of acute invasive fungal sinusitis and prompt treatment with antifungal medicine and surgical debridement are important in achieving better outcomes and survival rates. Level of Evidence 4

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Section: Discussionsupporting

confidence: 92%

Clinical and mycological investigations of post‐COVID‐19 acute invasive fungal sinusitis

Eldsouky

Shahat

AL-Tabbakh

et al. 2022

Laryngoscope Investig Oto

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“…The lack of routinely available fungal biomarker for mucormycosis results in delayed diagnosis; thus, CAM in patients with known co-morbidities (diabetes, transplantation, malignancies) and medications (steroids) has often fatal outcome ( Table 1 ; Monte Junior et al, 2020 ; Kanwar et al, 2021 ; Waizel-Haiat et al, 2021 ). Co-infections with multiple fungal species also worsen the survival rate of COVID-19 patients that was shown in a case report of combined aspergillosis and mucormycosis ( Benhadid-Brahmi et al, 2022 ).…”

Section: Mucormycosismentioning

confidence: 87%

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

Domán

Bányai

2022

Front. Microbiol.

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Secondary fungal infections may complicate the clinical course of patients affected by viral respiratory diseases, especially those admitted to intensive care unit. Hospitalized COVID-19 patients are at increased risk of fungal co-infections exacerbating the prognosis of disease due to misdiagnosis that often result in treatment failure and high mortality rate. COVID-19-associated fungal infections caused by predominantly Aspergillus and Candida species, and fungi of the order Mucorales have been reported from several countries to become significant challenge for healthcare system. Early diagnosis and adequate antifungal therapy is essential to improve clinical outcomes, however, drug resistance shows a rising trend highlighting the need for alternative therapeutic agents. The purpose of this review is to summarize the current knowledge on COVID-19-associated mycoses, treatment strategies and the most recent advancements in antifungal drug development focusing on peptides with antifungal activity.

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“…15 Benhadid-Bhrahmi et al reported a case of a previously immunocompetent patient with severe acute respiratory syndrome coronavirus 2 infection, complicated during the disease course with pulmonary Aspergillosis and Mucormycosis coinfection. 16 A case reported by Mohanty et al had a fungal storm with Aspergillosis and Mucormycosis and superadded Klebsiella in a post-COVID-19 patient. She was initially treated with voriconazole and later switched to liposomal amphotericin B when the diagnosis of mixed fungal disease was confirmed, along with antibiotics, surgical debridement, with supportive care.…”

Section: Discussionmentioning

confidence: 99%

Invasive mixed fungal disease after covid-19: A series of seven cases

Walke,

Jayashankar,

Karuna

et al. 2023

JLP

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Coronavirus disease 2019 (COVID-19) is a recent global pandemic that is caused by the novel severe acute respiratory syndrome coronavirus 2. The patients of COVID-19 are susceptible to a diverse range of secondary infections, fungal being the most common. The increased risk is proposed to be due to the generous use of steroids for the treatment of COVID-19 infection and the presence of comorbidities, such as diabetes mellitus, hypertension, preexisting lung diseases, and/or old age. Invasive mixed fungal disease is potentially life-threatening to the patients of COVID-19. In the present series of seven cases, the authors intend to discuss the clinicopathological profile and gamut of histopathological findings in invasive mixed fungal infection comprising of Mucor and Aspergillus in treated patients of COVID-19. Six patients had a clinical diagnosis of sinonasal–orbital invasive fungal disease, while there was a case of lung infection. The acquaintance and knowledge about histomorphology of invasive fungi and the multidisciplinary diagnostic approach not only will aid in early and accurate diagnosis but can guide the clinician for necessary surgical intervention and initiation of appropriate antifungal medications in patients of COVID-19.

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COVID-19-associated mixed mold infection: A case report of aspergillosis and mucormycosis and a literature review

Cited by 16 publications

References 58 publications

Clinical and mycological investigations of post‐COVID‐19 acute invasive fungal sinusitis

Clinical and mycological investigations of post‐COVID‐19 acute invasive fungal sinusitis

COVID-19-Associated Fungal Infections: An Urgent Need for Alternative Therapeutic Approach?

Invasive mixed fungal disease after covid-19: A series of seven cases

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