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Abstract
A wide range of bacterial and fungal coinfections may be associated with COVID-19. We report a case of rhino-orbital mucormycosis in a patient with COVID-19. A 67-year-old man, known case of diabetes, hypertension and ischaemic heart disease, was being treated for COVID-19 pneumonia when he developed right cheek eschar and ophthalmoplegia. Imaging studies revealed pansinusitis of bilateral maxillary and sphenoid sinuses with thickening and enhancement of right-sided soft tissue, lacrimal gland, mastication muscles, temporal lobe infiltrate and cerebellum infarct. Emergency right face debridement, right eye exenteration and bilateral functional endoscopic sinus surgery were done. Histopathological examination confirmed mucormycosis diagnosis. He was given amphotericin B and broad-spectrum antibiotics. It is important to have high index of suspicion for fungal coinfections in patients with COVID-19 with pre-existing medical conditions. There is a need to emphasise judicious and evidence-based use of immunomodulators in patients with COVID-19 to avoid triggering and flaring up of fungal infections.
- COVID-19
- nosocomial infections
- emergency medicine
- drugs: infectious diseases
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Footnotes
Contributors MS was involved in conception of the study and collected patient data (history and investigations) from various sources and interpreted them for the generation of this manuscript. He took part in writing the introduction and case presentation and participated in literature review. He also provided important intellectual input during critical review of the manuscript. MHAM was involved in the case presentation and discussion segment of the manuscript. He was also involved in data collection and interpretation, performed literature review and gave intellectual input during critical review of the manuscript. SW was involved in writing the discussion and conclusion segments and was involved in formatting of the final manuscript. He supervised the data collection and coordinated the critical revision process. All authors reviewed and approved the final draft of the manuscript for submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.