Disseminated Mucormycosis with Extensive Cardiac Involvement

Soliman, Mohanad; Harding, Cameron; Haddad, Hanine El; Mansour, Akila; Anstead, Michael

doi:10.7759/cureus.4760

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…Intake of food contaminated by fungal spores causes gastrointestinal mucormycosis, which is usually rare in immunocompetent patients but has been reported in patients associated with COVID-19 infection [10,11]. This condition might also typically have a poor prognosis, especially if it disseminates to the heart, usually diagnosed during an autopsy [12]. Renal mucormycosis is commonly observed in COVID-19 patients with kidney transplants and is often associated with poor prognosis [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Madhavan

Sai

Shanmugam

et al. 2022

JCM

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Mucormycosis has become increasingly associated with COVID-19, leading to the use of the term “COVID-19 associated mucormycosis (CAM)”. Treatment of CAM is challenging due to factors such as resistance to many antifungals and underlying co-morbidities. India is particularly at risk for this disease due to the large number of patients with COVID-19 carrying comorbidities that predispose them to the development of mucormycosis. Additionally, mucormycosis treatment is complicated due to the atypical symptoms and delayed presentation after the resolution of COVID-19. Since this disease is associated with increased morbidity and mortality, early identification and diagnosis are desirable to initiate a suitable combination of therapies and control the disease. At present, the first-line treatment involves Amphotericin B and surgical debridement. To overcome limitations associated with surgery (invasive, multiple procedures required) and amphotericin B (toxicity, extended duration and limited clinical success), additional therapies can be utilized as adjuncts or alternatives to reduce treatment duration and improve prognosis. This review discusses the challenges associated with treating CAM and the critical aspects for controlling this invasive fungal infection—early diagnosis and initiation of therapy, reversal of risk factors, and adoption of a multipronged treatment strategy. It also details the various therapeutic options (in vitro, in vivo and human case reports) that have been used for the treatment of CAM.

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Section: Introductionmentioning

confidence: 99%

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Madhavan

Sai

Shanmugam

et al. 2022

JCM

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“…Although the cardiovascular system is affected by definition, the mechanism of invasion being thrombosis and infarction, cases of cardiac mucormycosis are sporadic, many of them being included in disseminated forms, which means the involvement of at least two non-contiguous organs. Cardiac mucormycosis may be endocardial (the most frequent form), myocardial, pericardial, or mixed [3,[19][20][21][22][23][24][25][26][27][28][29][30]. Mucormycosis is a rare cause of endocarditis in intravenous drug users.…”

Section: Introductionmentioning

confidence: 99%

Disseminated Cunninghamella spp. Endocarditis in a Beta-Thalassemia Patient after Asymptomatic COVID-19 Infection

et al. 2022

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Cunninghamella spp. is a group of fungi belonging to the Mucorales order. Cases of fungal endocarditis are sporadic, but more frequent in immunocompromised patients. COVID-19 (SARS-CoV-2 Infection Disease 2019) infections, prematurity, deferoxamine treatment, iron overload, neutropenia, diabetes, and malignant hemopathies proved to be risk factors for mucormycosis. We present the case of a 7-year-old boy who was treated every three weeks with blood transfusion for major beta-thalassemia, receiving deferoxamine for secondary hemochromatosis. After two weeks with nonspecific respiratory and digestive symptoms, he was admitted for fever, followed by lower limb ischemia and neurological signs. Echocardiography revealed massive endocarditis affecting the mitral and tricuspid valves with embolization phenomena in the brain, lungs, kidney, spleen, and lower limbs. As a particular finding, IgG antibodies for COVID-19 were positive. Emergency cardiac surgery was performed. The mitral valve necessitated replacement with CarboMedics prosthesis. Unfortunately, the patient did not survive. Cunninghamella spp. was confirmed via the PCR analysis of vegetations. Cunninghamella endocarditis in the context of a systemic infection presented as an opportunistic infection affecting a child who had several risk factors. Mucormycosis is challenging to treat, with high mortality. Prophylactic treatment in beta-thalassemia patients with iron-chelator deprivation drugs, such as deferiprone, may help in preventing these particular fungal infections.

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Disseminated Mucormycosis with Extensive Cardiac Involvement

Cited by 2 publications

References 20 publications

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Current Treatment Options for COVID-19 Associated Mucormycosis: Present Status and Future Perspectives

Disseminated Cunninghamella spp. Endocarditis in a Beta-Thalassemia Patient after Asymptomatic COVID-19 Infection

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