Mucormycosis - A challenging diagnosis
Kumari S, Sachin S, Singh OK, Hossain N, Prasad A and Singh A
Published on: 2021-05-18
Abstract
Mucormycosis diagnosis is challenging, as it is associated with high mortality, especially in hematological patients. Early distinction from invasive aspergillosis is of utmost importance, as antifungal treatment may differ Mucormycosis are life-threatening fungal infections mostly occurring in hematology, solid organ transplant, or diabetic patients, it may also affect immunocompetent patients following a trauma or burn. Nosocomial or community outbreaks have been described. Mucormycosis is characterized by host tissue infarction and necrosis resulting from vasculature invasion by hyphae starting with a specific interaction with endothelial cells.
Keywords
Mucormycosis; Reverse Halo sign; PCR; Isavuconazole; Liposomal amphotericin BIntroduction
Post Covid tooth is aching??- Be careful
What is Mucormycosis?
It is rare but not new. Black fungus in patients with low immunity, high efficiency department and organ transplantation, such things are already happening but Covid-19 [1] is new and dangerous. Kavid- The sudden speed of infecting patients recovering well from 19 is a concern. The disease also known as zygomycosis is rare, according to the Centre of disease control & prevention, the CDC says [2]. In the last 15 days 8 to 10 cases of Mucormycosis caused by Covid-19 have been found at our center. This infection is caused by a fungus called Mucormycosis. This fungus exists naturally in the environment, but when the human body’s immunity is degraded, it infects the body. This fungus has adverse effects on the lungs and sinus when it enters the body through breathing [3]. This fungus can also enter the body through open wounds. The CDC has also clarified that Mucormycosis infection is not contagious means it does not infect humans [4] from one to another, from animals. Early and proper diagnosis and proper fungus resistant treatment methods are necessary for the patient to recover quickly [5].
Who is at risk of Mucormycosis?
Patients with [6] diabetes, hypertension, obesity, mean overall people whose immune system is weak are at higher risk of Mucormycosis.
Symptoms of Mucormycosis?
Swelling on one side of the mouth [7], brushing from the teeth, sharing teeth, jaw bone open, headache, sinus blood accumulation, eye swelling, decrease eye movement. Skin blackening in swollen places on the face, obstacles in the nose getting black dried crest in the nose.
Covid-19 And Mucormycosis
Mucormycosis is a disease that has diabetes, patients on steroids have low immunity [8], patients undergoing Covid-19 treatment are given steroids and some other medicines to cure their disease but it badly affects their immunity, all of this increases the risk of Mucormycosis [9-11].
How to diagnose Mucormycosis?
With the help of CT scan, endoscopy and biopsy, we can diagnose mucarmicosis early so if the above symptoms are found, you need to consult a dental and chief health specialist immediately.
What is the treatment for Mucormycosis?
It is necessary to adopt an immediate diagnosis and preventive treatment method (Antifungal therapy). But if the infection has reached other parts of the body, surgery may be required. Complications if treatment is delayed. The CDC says that the infection can lead to vision, as well as adverse effects on the nose and jaw bone and if the infection reaches the brain in fifteen days, the patient’s chance of death is 50 percent [12]. Hence, patients who have recovered from covid and especially those with diabetes and other diseases should get an oral health checkup without fail, because it is better to take care on time than to move forward. My heartfelt request to all the doctors treating covid-19 to advise all the cured and diabetic patients to conduct oral health checkup and I request all the dentists to examine such patients with dental complaints and give them proper advice should give [13 -15].
References
- Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005; 41:634-653.
- Alanio A, Desnos-Ollivier M, Garcia-Hermoso D, Bretagne S. Investigating Clinical Issues by Genotyping of Medically Important Fungi: Why and How? Clin Microbiol Rev. 2017; 30:671-707.
- Bitar D, Van Cauteren D, Lanternier F, Dannaoui E, Che D, et al. Increasing incidence of zygomycosis (mucormycosis), France, 1997-2006. Emerg Infect Dis. 2009;15 :1395- 1401
- Guinea J, Escribano P, Vena A, Munoz P, Padilla B et al. Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: Epidemiology and microbiological characterization of the isolates. PLoS One. 2017; 12: e0179136.
- Bitar D, Lortholary O, Le Strat Y, Nicolau J, Coignard B, et al. : Population-based analysis of invasive fungal infections, France, 2001-2010. Emerg Infect Dis. 2014; 20:1149-1155.
- Ribes JA, Vanover-Sams CL, Baker DJ: Zygomycetes in human disease. Clin Microbiol Rev. 2000; 13 :236-301.
- Katragkou A, Walsh TJ, Roilides E. Why is mucormycosis more difficult to cure than more common mycoses? Clin Microbiol Infect. 2014; 6:74- 81.
- Dannaoui E: Antifungal resistance in mucorales. Int J Antimicrob Agents. 2017; 50: 617-621.
- Lanternier F, Dannaoui E, Morizot G, Elie C, Hermoso G, et al. A global analysis of mucormycosis in France: the RetroZygo Study 2005-2007. Clin Infect Dis. 2012; 54:35-43.
- Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP. Pathogenesis of mucormycosis. Clin Infect Dis. 2012; 54 Suppl 1:16-22.
- Spellberg B, Edwards J, Jr, Ibrahim A: Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005; 18: 556- 69.
- Tedder M, Spratt JA, Anstadt MP, Hedge BS, Tedder SD. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg. 1994; 57: 1044-1050.
- Nam BD, Kim TJ, Lee KS, Kim TS, Han J, Chung MJ. Pulmonary mucormycosis: serial morphologic changes on computed tomography correlate with clinical and pathologic findings. Eur Radiol. 2018; 28:788-795.
- Dioverti MV, Cawcutt KA, Abidi M, et al. Gastrointestinal mucormycosis in immunocompromised hosts. Mycoses. 2015; 58:714-718.
- Singh N, Gayowski T, Singh J, Victor LY. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report and review of zygomycosis in solid-organ transplant recipients. Clin Infect Dis. 1995; 20:617-620.