Histomorphological features of mucormycosis with rise and fall of COVID-19 pandemic

Ganesan, Nidhya; Sivanandam, Shanthakumari

doi:10.1016/j.prp.2022.153981

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…In addition, studies including patients with invasive fungal infections in general, and not mucormycosis specifically, and studies including mucormycosis cases not associated with COVID-19 and not separately with CAM cases were excluded. Sixteen studies were excluded due to unavailable–insufficient information [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Four studies were excluded as they included patients with non-microbiologically confirmed SARS-CoV-2 infection [ 25 , 26 , 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Aspergillus fumigatus, Aspergillus niger and Aspergillus nidulans have been isolated [ 70 ], while mixed mold infections with Candida are also described in the literature [ 66 , 67 ]. Nidhya Ganesan et al reported that among 60 biopsy samples from suspected rhino-maxillary/rhino-orbital mucormycosis post COVID-19, mucorales was isolated in 58 (96.67%) samples, aspergillus along with mucorales in 12 (20%) and a combination of mucorales and candida in 8 (13.33%) [ 24 ].…”

Section: Diagnosismentioning

confidence: 99%

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Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

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A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.

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Section: Methodsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

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“…Physical examination reveals nasal and orbital cellulitis. This rapidly progresses to necrosis of the affected areas in association with fungal angioinvasion ( Ribes et al, 2000 ; Ganesan and Sivanandam, 2022 ).…”

Section: Clinical Presentation and Diagnosis Of Basidiobolomycosis Co...mentioning

confidence: 99%

An old confusion: Entomophthoromycosis versus mucormycosis and their main differences

Acosta-España

Voigt

2022

Front. Microbiol.

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Fungal diseases were underestimated for many years. And the global burden of fungal infections is substantial and has increased in recent years. Invasive fungal infections have been linked to several risk factors in humans which basically depend on the individual homeostasis of the patients. However, many fungi can infect even apparently healthy people. Knowledge of these pathogens is critical in reducing or stopping morbidity and/or mortality statistics due to fungal pathogens. Successful therapeutic strategies rely on rapid diagnosis of the causative fungal agent and the underlying disease. However, the terminology of the diseases was updated to existing phylogenetic classifications and led to confusion in the definition of mucormycosis, conidiobolomycosis, and basidiobolomycosis, which were previously grouped under the now-uncommon term zygomycosis. Therefore, the ecological, taxonomic, clinical, and diagnostic differences are addressed to optimize the understanding and definition of these diseases. The term “coenocytic hyphomycosis” is proposed to summarize all fungal infections caused by Mucorales and species of Basidiobolus and Conidiobolus.

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“…4 The order Mucorales has predominantly Rhizopus species including R. delemar and R. large number of reports of mucormycosis; approximately 50,000 cases. 5 Western region of India showed the highest number of reported cases followed by the South India. 5 The significant higher numbers in India can be attributed to uncontrolled diabetes, non-judicious use of steroids and humid weather conditions.…”

Section: Introductionmentioning

confidence: 99%

“…5 Western region of India showed the highest number of reported cases followed by the South India. 5 The significant higher numbers in India can be attributed to uncontrolled diabetes, non-judicious use of steroids and humid weather conditions. 3 As per previous reports, mucormycosis may develop in one fourth of the COVID19 patients, anywhere between 15 to 30 days after COVID19 infection and there was a lot media attention given to this entity due the color of the necrotic tissue as 'Black fungus'.…”

Section: Introductionmentioning

confidence: 99%

Histopathological spectrum of fungal infections in COVID 19 cases – A retrospective observational study

Mishra,

Patkar

2023

ACHR

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A wide range of fungal and bacterial infections are associated with Corona virus disease (COVID19). There was a surge of mucormycosis during COVID19 pandemic in 2021. This study elaborates the histopathological findings observed in fungal infections of head and neck in COVID 19 patients. A retrospective observational study of histopathological findings of invasive fungal infection in COVID 19 case was conducted in our laboratory. All the tissue samples diagnosed as post COVID fungal infections during January 2021 to June 2021 were analyzed. Representative sections were taken and slides were stained with Hematoxylin & Eosin, Periodic Acidic Schiff (PAS) and Gomori Methenamine silver (GMS) stains. Histopathological features were studied. There were total 32 cases which had invasive fungal infections associated with COVID 19. The most affected age group was 31 to 50 years of age (50%), with male preponderance (87.5%). Diabetes was present in 62.5% cases, and steroid use during the treatment was present in 31.3% of the cases. The most common site was maxillary sinus (53.1%) followed by nasal cavity (34.4%). Isolated infection by mucor was seen in 68.8% cases, there were cases of secondary bacterial infection and candida with aspergillus infection. Angioinvasion was present in 56.3% cases and bone destruction in 15.6% cases.COVID 19 infection results in immune dysregulation and background of diabetes and over use of steroids increases risk of mucormycosis. An early histopathological diagnosis provides early diagnosis.

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Histomorphological features of mucormycosis with rise and fall of COVID-19 pandemic

Cited by 10 publications

References 30 publications

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

An old confusion: Entomophthoromycosis versus mucormycosis and their main differences

Histopathological spectrum of fungal infections in COVID 19 cases – A retrospective observational study

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