Managing mucormycosis in diabetic patients: A case report with critical review of the literature

Beiglboeck, Fabian M; Theofilou, Nantia E; Fuchs, M; Wiesli, Matthias Guido; Leiggener, Christoph; Igelbrink, Sebastian; Augello, Marcello

doi:10.1111/odi.13802

Cited by 16 publications

(28 citation statements)

References 52 publications

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“…Involvement of the vessels disturbs the blood supply; the necrotic process begins, where the characteristic mycotic dark patch is noticed, demonstrated in figure 1. Mucormycosis can be subdivided into five types; the most frequently seen is Rhino-orbital-cerebral [9,10]. Other types include pulmonary, cutaneous, gastrointestinal, and disseminated MM.…”

Section: Course Of Infectionmentioning

confidence: 99%

Mucormycosis in COVID-19 Diabetic Patient

Nori¹,

Norri²

2021

Proceedings of the 1st International Ninevah Conference on Medical Sciences (INCMS 2021)

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Mucormycosis is an unusual and potentially lethal invasive infection of fungi that most commonly affects diabetes and other immunocompromised individuals. This infection showed high morbidity and mortality rate. Furthermore, the rapidity with which mucormycosis spreads is an extraordinary phenomenon; even a minor delay in diagnosis can be lethal. COVID-19-associated mucormycosis has been documented more frequently recently, notably among cases with uncontrolled diabetes. Patients with type I diabetes mellitus and hyperglycemia often have an inflammatory condition exacerbated by suppressed immunity triggered by SARS-CoV-2, making secondary infections more likely. Reports of mucormycosis in Iraq is scrutinized; therefore, we aimed to discuss the infection's epidemiological criteria, risk factors, and pathogenesis as we present a young child case report who suffered from a tragic course.

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Section: Course Of Infectionmentioning

confidence: 99%

Mucormycosis in COVID-19 Diabetic Patient

Nori¹,

Norri²

2021

Proceedings of the 1st International Ninevah Conference on Medical Sciences (INCMS 2021)

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“…Antifungal like intravenous amphotericin B or isuvaconazole, followed by oral posaconazole are the main medical therapy, with good debridement of local nasal tissue debris, transcutaneous retrobulbar amphotericin B injections, timely exenteration being the corner-stone of treatment [ 23,24,25,26,27,28,29] . Sustained euglycaemia yields better results in outcome [30,31,32,33,33,34,35,36,37] Objective This case series of 13 patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India.…”

Section: Introductionmentioning

confidence: 98%

Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

Verma

Chakraborty

et al. 2022

Preprint

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Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

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“…Hematological malignancy, diabetes mellitus, corticosteroid treatment, exposure to skin burns to the environment, and solid organ transplants increase the risk of mucormycosis [ 3 ]. Mucormycosis has plagued the world for 5 decades, but little is known about its causative agents, pathogenesis, and epidemiology [ 4 ]. Therefore, therapeutic approaches to treat this problem are also scarce [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Mucormycosis has a wide range of clinical manifestations, based on the host’s pre-existing immunosuppression. Even though there is substantial diversity, the clinical manifestation may be generally classified into six categories, ROCM [ 4 ], pulmonary [ 14 ], gastrointestinal, cutaneous [ 15 ], disseminated, and renal mucormycosis [ 16 ], based on anatomic predilection. Among its causative agents, Rhizopus organisms are said to be behind ROCM, Saksenaea and Apophysomyces are usually identified in cutaneous mucormycosis, and Cunninghamella organisms are usually associated with disseminated and pulmonary forms of the infection [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Vaccine Construction against COVID-19-Associated Mucormycosis Contrived with Immunoinformatics-Based Scavenging of Potential Mucoralean Epitopes

et al. 2022

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Mucormycosis is a group of infections, caused by multiple fungal species, which affect many human organs and is lethal in immunocompromised patients. During the COVID-19 pandemic, the current wave of mucormycosis is a challenge to medical professionals as its effects are multiplied because of the severity of COVID-19 infection. The variant of concern, Omicron, has been linked to fatal mucormycosis infections in the US and Asia. Consequently, current postdiagnostic treatments of mucormycosis have been rendered unsatisfactory. In this hour of need, a preinfection cure is needed that may prevent lethal infections in immunocompromised individuals. This study proposes a potential vaccine construct targeting mucor and rhizopus species responsible for mucormycosis infections, providing immunoprotection to immunocompromised patients. The vaccine construct, with an antigenicity score of 0.75 covering, on average, 92–98% of the world population, was designed using an immunoinformatics approach. Molecular interactions with major histocompatibility complex-1 (MHC-I), Toll-like receptors-2 (TLR2), and glucose-regulated protein 78 (GRP78), with scores of −896.0, −948.4, and −925.0, respectively, demonstrated its potential to bind with the human immune receptors. It elicited a strong predicted innate and adaptive immune response in the form of helper T (Th) cells, cytotoxic T (TC) cells, B cells, natural killer (NK) cells, and macrophages. The vaccine cloned in the pBR322 vector showed positive amplification, further solidifying its stability and potential. The proposed construct holds a promising approach as the first step towards an antimucormycosis vaccine and may contribute to minimizing postdiagnostic burdens and failures.

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Managing mucormycosis in diabetic patients: A case report with critical review of the literature

Abstract: Mucormycosis (formerly synonym zygomycosis) is a rare and potentially fatal invasive fungal infection caused by the Mucorales order, to which the species Rhizopus spp, Mucor spp, Rhizomucor

Cited by 16 publications

References 52 publications

Mucormycosis in COVID-19 Diabetic Patient

Mucormycosis in COVID-19 Diabetic Patient

Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

A Vaccine Construction against COVID-19-Associated Mucormycosis Contrived with Immunoinformatics-Based Scavenging of Potential Mucoralean Epitopes

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