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Case Reports
. 2021 Sep 3;21(1):906.
doi: 10.1186/s12879-021-06625-3.

A case report of rhino-facial mucormycosis in a non-diabetic patient with COVID-19: a systematic review of literature and current update

Faezeh Mohammadi  1 , Milad Badri  2   3 , Shapoor Safari  4 , Nima Hemmat  5
Affiliations
Case Reports

A case report of rhino-facial mucormycosis in a non-diabetic patient with COVID-19: a systematic review of literature and current update

Faezeh Mohammadi et al. BMC Infect Dis. .

Abstract

Background: COVID-19 disease may be associated with a wide range of bacterial and fungal infections. We report a patient with COVID-19 infection who developed rhino-facial mucormycosis during treatment with corticosteroids.

Case presentation: A 59-year-old non-diabetic male patient was admitted with a diagnosis of COVID-19 based on positive RT-PCR and CT of the lungs. Due to sever lung involvement, he was treated with methylprednisolone. The patient was re-admitted to hospital, due to nasal obstruction and left side facial and orbital swelling, several days after discharge. In sinus endoscopic surgery, debridement was performed and the specimens were sent to pathology and mycology laboratories. A nasal biopsy showed wide hyphae without septa. The sequenced PCR product revealed Rhizopus oryzae. Despite all medical and surgical treatment, the patient died. In addition, the characteristics of patients with COVID-19-associated mucormycosis were reviewed in 44 available literatures. In most studies, diabetes mellitus was the most common predisposing factor for mucormycosis.

Conclusion: Our report highlights the need for assessing the presence of mucormycosis in patients with COVID-19 and also it shows that physicians should consider the potential for secondary invasive fungal infections in COVID-19 cases.

Keywords: COVID-19; Mucormycosis; Rhizopus oryzae.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Fig. 1
Fig. 1
Computed tomography (CT) scan of the chest of a patient with COVID-19 shows multiple patchy ground-glass opacities
Fig. 2
Fig. 2
CT scan shows involvement of the left ethmoid, sphenoid, maxillary and paranasal sinuses in a patient with mucormycosis
Fig. 3
Fig. 3
a Presence of irregular and non-septate hyphae in H&E staining of pathology. b Observation of broad aseptate hyphae in surgical debridement in direct examination (10% KOH). c and d Lactophenol cotton blue (LCB) mount showed nonseptate hyphae, rhizoids and spore-filled sporangiophores
Fig. 4
Fig. 4
The phylogenetic tree of isolates of Rhizopus oryzae. Based on ITS sequence from a patient with mucormycosis and GenBank sequences of some related species were estimated in MEGA7 using the ML analyses based on 1,000 bootstrap replications
See this image and copyright information in PMC

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