Covid-19 and acute invasive rhinosinusitis secondary to mucormycosis: report of two cases in Colombia

COVID-19 y rinosinusitis invasiva aguda secundaria a mucormicosis: a propósito de 2 casos en Colombia

Introduction: mucormycosis is a rare fungal infection, also known as zygomycosis or phycomycosis. It features low prevalence and high mortality rate. It usually affects patients with altered immunity precipitated by COVID-19 infection. This co-infection is associated with high mortality rate and sequelae in affected patients. Case report: we present two cases of rhino-cerebral mucormycosis co-infection in COVID-19 patients, the provided treatment, and outcomes.     

1. Fanelli D, Piazza F. Analysis and forecast of COVID-19 spreading in China, Italy and France. Chaos Solitons Fractals. 2020;134:109761 https://doi.org/https://doi.org/10.1016/j.chaos.2020.109761
2. Ministerio de Salud y Protección Social. Vacunación contra COVID-19 [Internet]. 2021 (Consultado 2021). Disponible en: https://www.minsalud.gov.co/salud/publica/Vacunacion/Paginas/Vacunacion-covid-19.aspx
3. Vieira Rezende RP, Braz AS, Guimarães MFB, Ribeiro E SL, Abreu Vieira RM, Bica BE, Cruz VA, Libardi Lira Machado KL, Carvalho JS, et al. Characteristics associated with COVID-19 vaccine hesitancy: A nationwide survey of 1000 patients with immune-mediated inflammatory diseases. Vaccine. 2021;39(44):6454-6459. https://doi.org/https://doi.org/10.1016/j.vaccine.2021.09.057
4. Elguera-Falcón F, Cumpa-Quiróz R. Mucormicosis en pacientes diabéticos post infección por COVID-19. Rev Soc Peru Med Interna. 2020;33(4): 176-182. https://doi.org/10.36393/spmi.v33i4.568
5. Lee DH, Yoon TM, Lee JK, Joo YE, Park KH, Lim SC. Invasive fungal sinusitis of the sphenoid sinus. Clin Exp Otorhinolaryngol. 2014;7(3):181-187. doi: 10.3342/ceo.2014.7.3.181
6. Park YL, Cho S, Kim J-W. Mucormycosis originated total maxillary and cranial base osteonecrosis: a possible misdiagnosis to malignancy. BMC Oral Health. 2021;21(1):65. doi: 10.1186/s12903-021-01411-8
7. García K, Iracheta R, Salas Á, Saldías N, Zamorano R, Boettiger P. Mucormicosis rino-órbito-cerebral crónica: una patología poco frecuente. Rev. Otorrinolaringol. Cir. Cabeza Cuello. 2020;80:297-306. http://dx.doi.org/10.4067/S0718-48162020000300297
8. Mogollón-Gil B, Díaz-Carbajal D, Echeverría J, Cotí M. Mucormicosis post-COVID-19. Rev. méd. (Col. Méd. Cir. Guatem). 2021;160(3):260-262. https://doi.org/10.36109/rmg.v160i3.414
9. Aribandi M, McCoy VA, Bazan III C. Imaging features of invasive and noninvasive fungal sinusitis: a review. Radiographics. 2007;27(5):1283–96. doi: 10.1148/rg.275065189
10. Chan L-L, Singh S, Jones D, Diaz Jr EM, Ginsberg LE. Imaging of mucormycosis skull base osteomyelitis. AJNR Am J Neuroradiol. 2000;21(5):828–831.
11. Fernández NB. Las infecciones fúngicas en la pandemia de COVID-19, el caso de la mucormicosis. Rev Argent Microbiol. 2021;53(3):181-182. doi: 10.1016/j.ram.2021.09.001
12. Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DCM, Chen SCA. The epidemiology and clinical manifestations of mucormycosis: A systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019;25(1):26–34. https://doi.org/10.1016/j.cmi.2018.07.011
13. Malhotra HS, Gupta P, Mehrotra D, Dandu H, Kohli N, Verma V, Puri B. COVID-19 associated mucormycosis: Staging and management recommendations (Report of a multi-disciplinary expert committee). J Oral Biol Craniofac Res. 2021;11(4):569-580. doi: 10.1016/j.jobcr.2021.08.001
14. O’Neill B, Alessi A, George E, Piro J. Disseminated rhinocerebral mucormycosis: a case report and review of the literature. J Oral Maxillofacial Surg. 2006;64(2):326-333. doi: 10.1016/j.joms.2005.10.017
15. Castrejón AJ, Crespó Reinoso PA. Mucormicosis rinocerebral: reporte de un caso y revisión de la literatura. Rev Mex Cir Bucal Maxilofac. 2020;16(1):22–26. https://dx.doi.org/10.35366/93384
16. Prakash H, Chakrabarti A. Global epidemiology of mucormycosis. J Fungi (Basel). 2019;5(1):26. doi: 10.3390/jof5010026
17. Prakash H, Chakrabarti A. Epidemiology of mucormycosis in India. Microorganisms. 2021;9(3):523. https://doi.org/10.3390/microorganisms9030523
18. Zuniga, MG, Turner JH. Treatment outcomes in acute invasive fungal rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2014;22(3):242-8. doi: 10.1097/MOO.0000000000000048
19. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SC, Dannaoui E, Hochhegger B, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19(12):e405-e421. doi: 10.1016/S1473-3099(19)30312-3 e421
20. Baldin C, Ibrahim A.S. Molecular mechanisms of mucormycosis—the bitter and the sweet. PLoS pathogens. 2017;13(8):e1006408. doi: 10.1371/journal.ppat.1006408
21. Pemán J, Ruiz-Gaitán A, García-Vidal C, Salavert M, Ramírez P, Puchades F, Quindós G. Fungal co-infection in COVID-19 patients: Should we be concerned?. Rev Iberoam Micol. 2020;37(2):41-46. doi: 10.1016/j.riam.2020.07.001