Mucormycosis treatment: Recommendations, latest advances, and perspectives

Brunet, Kévin; Rammaert, Blandine

doi:10.1016/j.mycmed.2020.101007

Cited by 93 publications

(111 citation statements)

References 115 publications

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“…Suspected and/or confirmed mucormycosis requires consultation with the surgical team [7]. It is crucial that there are clean margins during surgical debridement to stop the spread of the fungal infection.…”

Section: Discussionmentioning

confidence: 99%

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Rhinocerebral Mucormycosis and COVID-19 Pneumonia

Alekseyev¹,

Didenko²,

2021

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As the coronavirus disease 2019 (COVID-19) pandemic is evolving, more complications associated with COVID-19 are emerging. In this case report, we present a case of rhinocerebral mucormycosis concurrent with COVID-19 pneumonia in a 41-year-old man with a history of type 1 diabetes mellitus (T1DM). COVID-19 pneumonia was diagnosed with reverse transcription-polymerase chain reaction (RT-PCR). He was promptly treated with steroids and hydroxychloroquine, as this was the recommended regional COVID-19 practice patterns at the time. He was treated with intravenous (IV) fluids and an insulin drip for his diabetic ketoacidosis (DKA), cefepime and IV abelcet, along with three surgical debridements for the rhinocerebral mucormycosis. The pneumonia resolved during the course of his stay in the hospital. With prompt diagnosis and treatment of rhinocerebral mucormycosis, the patient was cleared for discharge and was instructed to complete his course of treatment with coumadin and IV abelcet at home. Saprophytic fungi cause rhinocerebral mucormycosis, a rare opportunistic infection of the sinuses, nasal passages, oral cavity and brain. It usually occurs in patients with poorly controlled diabetes mellitus or those who are immunocompromised, which is again demonstrated in this case report. In the setting of COVID-19 pneumonia and an underlying condition, healthcare professionals should act promptly. In cases where mucormycosis infection is suspected, a prompt diagnosis and treatment should be started because of the angioinvasive character and rapid disease progression that contribute to the severity of the mucormycosis infection.

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Section: Discussionmentioning

confidence: 99%

“…Regarding uncontrolled diabetes mellitus, it is vital to correct the hyperglycemia and ketoacidosis [2]. According to Brunet, the prompt control of hyperglycemia and the reversal of ketoacidosis have led to the best outcomes [7]. Additionally, tapering immunosuppressive therapy may play an additional role in the treatment of mucormycosis.…”

Section: Discussionmentioning

confidence: 99%

Rhinocerebral Mucormycosis and COVID-19 Pneumonia

Alekseyev¹,

Didenko²,

2021

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“…However, in SARS-CoV-2 infection, the mortality maybe even higher. 58 The prescription of immunosuppressing drugs can lead to life-threatening opportunistic infections in patients with COVID-19, and the lack of substantial evidence for many of these therapies calls for an urgent reassessment of the current treatment guidelines for COVID-19, including monitoring for opportunistic fungal infections. The rationale and benefit of administering steroids in patients with COVID-19 need continuous reappraisal to avoid the increasing number of iatrogenic deaths linked to steroid overuse in those with SARS-CoV-2 infection.…”

mentioning

confidence: 99%

COVID-19 associated mucormycosis: the urgent need to reconsider the indiscriminate use of immunosuppressive drugs

Rodríguez-Morales

Sah

Millán-Oñate³

et al. 2021

Therapeutic Advances in Infection

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“…Adequate surgical debridement is reported as an independent predictor for favorable outcomes in GIMM. Apart from this, the guidelines recommend long-term treatment with liposomal amphotericin B and posaconazole which have activity against Mucorales [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Synchronous Small Bowel Gangrene With Pyelonephritis Secondary to Mucormycosis: A Disastrous Complication of COVID-19 Pandemic

Varshney¹,

Swami²,

Thirunavukkarasu³

et al. 2021

Cureus

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Mucormycosis is a rare infection caused by fungi of the order Mucorales. The infection frequently involves the rhino-cerebral or respiratory system and involvement of the gastrointestinal (GI) tract and kidney are rare. It usually infects immunocompromised individuals due to various causes and an upsurge is hypothesized to be linked with irrational use of steroids during coronavirus disease 2019 (COVID-19) pandemic.We encountered a rare case of systemic mucormycosis that involved both renal as well as mesenteric vessels and led to ischemia of both vital organs. The patient developed massive bowel gangrene involving the duodenum, proximal jejunum, and left kidney due to angioinvasive mucormycosis.The diagnosis of GI mucormycosis may further increase during the current pandemic. The physicians, as well as surgeons, should be aware of this unwanted complication and keep a high index of suspicion for this rare disease.

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Mucormycosis treatment: Recommendations, latest advances, and perspectives

Cited by 93 publications

References 115 publications

Rhinocerebral Mucormycosis and COVID-19 Pneumonia

Rhinocerebral Mucormycosis and COVID-19 Pneumonia

COVID-19 associated mucormycosis: the urgent need to reconsider the indiscriminate use of immunosuppressive drugs

Synchronous Small Bowel Gangrene With Pyelonephritis Secondary to Mucormycosis: A Disastrous Complication of COVID-19 Pandemic

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