Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19

Rodrigues, Mariana Gonçalves; Sekiguchi, William Kazunori; Gonçalves, Sérgio; Casal, Yuri Reis; Frassetto, Fernando Pereira; Silva, Vinicius Trindade Gomes da; Santo, Marcelo Prudente do Espírito; Magri, Marcello Mihailenko Chaves

doi:10.4322/acr.2021.345

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Clinical Case Report • Autops. Case Rep. 12 • 2022 • https://doi.org/10.4322/acr.2021.345 copy

Loss of an eye to mucormycosis following corticosteroid therapy for COVID-19

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Mucormycosis is a rare, sometimes severe fungal infection that has emerged as a possible complication of COVID-19. We report a case of a non-diabetic, apparently immunocompetent patient diagnosed with rhino-orbital-cerebral mucormycosis shortly after COVID-19 treatment with dexamethasone. The patient received optimized systemic antifungal therapy and extensive surgical treatment. So far, four months after the last hospital discharge, the patient has been in good general condition. This case is a dramatic reminder that beneficial corticosteroid therapy in general inevitably carries a risk of opportunistic infection, and corticosteroid therapy for COVID-19 risks orbital-rhinocerebral mucormycosis that clinicians should watch for with vigilance.

Keywords:; Immunocompetence; SARS-CoV-2; Orbit

	result	RV		result	RV
HbA1c	5.5%	4.7-5.6%	Proteins	7.6 g/dL	6-8 g/dL
Leukocytes	9300/mm³	4000-11000/mm³	albumin	5 g/dL	3.2-5.0 g/dL
Neutrophils	5520/mm³	2500-7500/mm³	Alfa-1 g	0.3 g/dL	0.1-0.3 g/dL
Lymphocytes	2430/mm³	1500-3500/mm³	Alfa-2 g	0.7 g/dL	0.6-1.0 g/dL
Monocytes	880/mm³	200-800/mm³	Beta-1 g	0.5 g/dL	0.4-0.7 g/dL
Basophils	100/mm³	0-100/mm³	Beta-2 g	0.3 g/dL	0.3-0.4 g/dL
Eosinophils	370/mm³	4-440/mm³	Gamma g	0.7 g/dL	0.8-1.6 g/dL
Platelets	199.10³/mm³	15010³-40010³/mm³	HIV	Non-reactive	Non-reactive

Hospital Universitário da Universidade de São Paulo Hospital Universitário da Universidade de São Paulo, Av. Prof. Lineu Prestes, 2565 - Cidade Universitária, 05508-000 - São Paulo - SP - Brasil, (16) 3307-2068, (16) 3307-2068 - São Paulo - SP - Brazil
E-mail: autopsy.hu@gmail.com

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[1] Authors’ contributions: Mariana Gonçalves Rodrigues was responsible for data collection, case review and manuscript writing. William Kazunori Sekiguchi was responsible for data collection, data analysis and manuscript review. Sérgio Gonçalves was responsible for the study design, data analysis and manuscript review. Yuri Reis Casal was responsible for data collection and manuscript review. Fernando Pereira Frassetto was responsible for and manuscript review. Vinicius Trindade Gomes da Silva was responsible for manuscript review. Marcelo Prudente do Espírito Santo was responsible for manuscript review. Marcello Mihailenko Chaves Magri was responsible for data analysis and manuscript review.