Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19
Background: The most common causes of immunodeficiency are iatrogenic and the result of the widespread use of therapies which modulates the immune system, whether they are planned or haphazardly. Mucormycosis is an invasive fungal disease which is usually secondary to immunosuppression, diabetic ket...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Babol University of Medical Sciences
2022-01-01
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| Series: | Caspian Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://caspjim.com/article-1-2692-en.html |
| _version_ | 1819209696877215744 |
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| author | Masoud Mardani Ilad Alavi Darazam Abdolreza Babamahmoodi |
| author_facet | Masoud Mardani Ilad Alavi Darazam Abdolreza Babamahmoodi |
| author_sort | Masoud Mardani |
| collection | DOAJ |
| description | Background: The most common causes of immunodeficiency are iatrogenic and the result of the widespread use of therapies which modulates the immune system, whether they are planned or haphazardly. Mucormycosis is an invasive fungal disease which is usually secondary to immunosuppression, diabetic ketoacidosis, and long-term use of antibiotics, corticosteroids, and cytotoxic drugs. There are researches which show patients with coronavirus disease 2019 (COVID-19), especially severely ill or immunocompromised, are more likely to suffer from invasive fungal infections. Patients with diabetes are at a higher risk for severe COVID-19 outcomes. However, there has been no clear evidence on the relationship between pre-diabetes state and mucormycosis as a complication of SARS-CoV-2 infection so far.
Case Presentation: Here, we report a case of sino-orbital mucormycosis in a pre-diabetic 54-year-old female without any underlying diseases. The patient suffered from COVID-19 pneumonia. She received 8 mg dexamethasone for 12 days. Afterwards, she returned three days after her discharge with a complaint of pre-orbital cellulitis, unilateral facial numbness and decreased visual acuity. Therefore, after primary diagnostic imaging, she was regarded as a candidate for invasive surgical intervention and was consequently treated with a combination of liposomal amphotericin B, radical recurrent surgery and posaconazole.
Conclusion: It is very important to consider patients who are in the pre-diabetic state or possibly immunocompromised before prescribing steroids. The patients should be examined for invasive fungal infections in post-discharge period. |
| first_indexed | 2024-12-23T05:59:24Z |
| format | Article |
| id | doaj.art-a90eb515296141b886e8f1718c296208 |
| institution | Directory Open Access Journal |
| issn | 2008-6164 2008-6172 |
| language | English |
| last_indexed | 2024-12-23T05:59:24Z |
| publishDate | 2022-01-01 |
| publisher | Babol University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Internal Medicine |
| spelling | doaj.art-a90eb515296141b886e8f1718c2962082022-12-21T17:57:42ZengBabol University of Medical SciencesCaspian Journal of Internal Medicine2008-61642008-61722022-01-0113Covid 19 Supplement 2277280Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19Masoud Mardani0Ilad Alavi Darazam1Abdolreza Babamahmoodi2 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical, Tehran, Iran Background: The most common causes of immunodeficiency are iatrogenic and the result of the widespread use of therapies which modulates the immune system, whether they are planned or haphazardly. Mucormycosis is an invasive fungal disease which is usually secondary to immunosuppression, diabetic ketoacidosis, and long-term use of antibiotics, corticosteroids, and cytotoxic drugs. There are researches which show patients with coronavirus disease 2019 (COVID-19), especially severely ill or immunocompromised, are more likely to suffer from invasive fungal infections. Patients with diabetes are at a higher risk for severe COVID-19 outcomes. However, there has been no clear evidence on the relationship between pre-diabetes state and mucormycosis as a complication of SARS-CoV-2 infection so far. Case Presentation: Here, we report a case of sino-orbital mucormycosis in a pre-diabetic 54-year-old female without any underlying diseases. The patient suffered from COVID-19 pneumonia. She received 8 mg dexamethasone for 12 days. Afterwards, she returned three days after her discharge with a complaint of pre-orbital cellulitis, unilateral facial numbness and decreased visual acuity. Therefore, after primary diagnostic imaging, she was regarded as a candidate for invasive surgical intervention and was consequently treated with a combination of liposomal amphotericin B, radical recurrent surgery and posaconazole. Conclusion: It is very important to consider patients who are in the pre-diabetic state or possibly immunocompromised before prescribing steroids. The patients should be examined for invasive fungal infections in post-discharge period.http://caspjim.com/article-1-2692-en.htmlcovid-19dexamethasonemucormycosissars-cov-2steroids |
| spellingShingle | Masoud Mardani Ilad Alavi Darazam Abdolreza Babamahmoodi Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 Caspian Journal of Internal Medicine covid-19 dexamethasone mucormycosis sars-cov-2 steroids |
| title | Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 |
| title_full | Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 |
| title_fullStr | Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 |
| title_full_unstemmed | Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 |
| title_short | Dexamethasone induced Sino-orbital Mucormycosis in a Patient Infected with COVID-19 |
| title_sort | dexamethasone induced sino orbital mucormycosis in a patient infected with covid 19 |
| topic | covid-19 dexamethasone mucormycosis sars-cov-2 steroids |
| url | http://caspjim.com/article-1-2692-en.html |
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