Document Type : Case Reports
Authors
- Arezoo Salami 1
- Mahsa Falahatinejad 2
- Mahsa Abdorahimi 3
- Mohammadreza Salehi 4
- Farzad Aala 5
- Alireza Abdollahi 6
- Hana Saffar 7
- Sadegh Khodavaisy 8
1 Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Medical Mycology, Tarbiat Modares University, Tehran, Iran
3 Department of Microbiology, Shahr‑e‑Qods Branch, Islamic Azad University, Tehran, Iran
4 Department of Infectious and Tropical Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
6 Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Iran
8 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract
There has been a rise in COVID-19-associated mucormycosis (CAM) cases, particularly in low-income countries. We describe a case of primary cutaneous mucormycosis after recovering from COVID-19 in a kidney transplant recipient who had a known case of diabetes mellitus. The patient developed cutaneous ulcers due to Rhizopus oryzae in the right hand. She did not recall any trauma or injury at the affected site. Based on the appearance of the wound we suspected that healthcare-associated mucormycosis could be the causative agent. Due to the initial misdiagnosis as a bacterial infection, the appropriate treatment was delayed, and the lesions progressed rapidly to necrotic ulcers with jagged margins that deteriorated during hospitalization. She underwent consecutive surgical interventions and received broad-spectrum antifungal therapy. Finally, the patient deceased after 32 days of hospital stay. We reviewed the previous case reports of cutaneous mucormycosis occurring in COVID-19 patients and described patient characteristics, predisposing factors, location of ulcers, clinical presentation, management, and outcome. This report and existing published literature indicate a poor outcome for cutaneous mucormycosis in COVID-19 patients and the importance of early diagnosis, aggressive multidisciplinary management, and regular follow-up as a life-saving measure, especially in immunocompromised patients.
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Main Subjects
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