COVID-19 associated pulmonary mucormycosis: case report and systematic literature review
Keywords:
COVID-19, Pulmonary mucormycosis, Glucocorticoids, Diabetes mellitusAbstract
Systemic glucocorticoids, widely used in the management of severe COVID-19, are known to increase susceptibility to opportunistic fungal infections. While COVID-19–associated pulmonary aspergillosis is well documented, mucormycosis remains comparatively rare. We report a probable case of pulmonary mucormycosis in a 55-year-old man with diabetes, end-stage kidney disease, and severe COVID-19. The infection developed 21 days after hospitalization, and the patient was successfully treated with liposomal amphotericin B, completing a total dose of 5 g, and was discharged after 54 days.
A systematic literature review identified seven additional cases of COVID-19–associated mucormycosis (CAM). Diabetes mellitus emerged as the most frequent predisposing condition; however, three patients had no identifiable risk factor other than glucocorticoid therapy. In most cases, CAM developed 10–14 days after admission. Except for our case, all reported patients had fatal outcomes, with two diagnoses made postmortem.
Although uncommon, mucormycosis represents a serious and life-threatening complication of severe COVID-19. Patients with diabetes or multiple predisposing conditions appear particularly vulnerable, and glucocorticoid exposure may further elevate this risk. Early recognition and prompt, aggressive antifungal treatment are critical to improving survival.
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