دورية أكاديمية
Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics
| العنوان: | Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics |
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| المؤلفون: | Anna Yu. Popova, Yulia V. Demina, Natalya N. Zaytseva, Natalya S. Kucherenko, Arkadyi N. Denisenko, Anna G. Tochilina, Irina V. Belova, Grigoryi A. Belozerov, Anastasia V. Polyanina, Natalya A. Sadykova, Irina V. Soloveva |
| المصدر: | Инфекция и иммунитет, Vol 12, Iss 4, Pp 790-797 (2022) |
| بيانات النشر: | NIIÈM imeni Pastera, 2022. Sankt-Peterburg , 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Infectious and parasitic diseases |
| مصطلحات موضوعية: | covid-19, rhino-orbital mucormycosis, lichtheimia corymbifera, fungal morphology, maldi-tof mass spectrometry, long-covid, Infectious and parasitic diseases, RC109-216 |
| الوصف: | According to current data, SARS-CoV-2 virus has the ability to cause multi-organ pathology, leading to acute damage of various organs and systems and long-term consequences characterized by polymorphic symptoms. Recently, a high incidence of invasive mycoses, particularly mucormycosis COVID-M, has been noted among the COVID-19 complications. The predisposing factor for the development of this pathology is diabetes mellitus, immunodeficiency states, and prolonged use of high doses of glucocorticosteroids. Mucormycosis is characterized by severe clinical manifestations and high lethality, and timely diagnostics of this pathology often represents a difficult problem. The aim of this study was to analyze a clinical case of rhino-orbital mucormycosis in convalescent COVID-19 patient. In the study, there was used mucopurulent nasal discharge from the patient previously hospitalized with a severe novel coronavirus infection. Here, we describe the methodology allowing to isolate and identify a pure mold fungus culture from the biomaterial using methods of routine bacteriology and MALDI-ToF mass spectrometry. Direct microscopy examination of nasal cavity discharge revealed branched non-septic hyphae with a characteristic branching angle, allowing to preliminarily diagnose invasive mucormycosis. Growth of mycelial fungus colony was observed by using Sabourauds medium with potassium tellurite. Microscopy of the pure culture revealed branching mycelium without septa, broad, with irregular thickness, unsegregated hyphae, and sporangia with a typical column specific to mucormycetes. Analysis of the obtained mass spectra allowed to establish the microbial species identity as Lichtheimia corymbifera. The latter along with other members of the order Mucorales, are known to cause mucormycosis. As a result of antifungal treatment (Amphotericin B) and timely surgical intervention, the patient was discharged from the hospital with prominent clinical improvement and no complaints during further outpatient follow-up period. The analysis of this clinical case showed the lack of alertness in some clinical diagnostic laboratories to detect pathogens of invasive mycoses. To avoid errors, while making a diagnosis, attention should be paid not only to detection of fungal spores in clinical material, but also take into account the structure of mycelium underlying major difference between yeast-like fungi, higher and lower molds. The isolation and identification of a pure pathogen culture allows to confidently verify the diagnosis, timely correct the treatment tactics and monitor circulation of mycotic agents to prevent occurrence of mycoses in most vulnerable patients cohorts. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | Russian |
| تدمد: | 2220-7619 2313-7398 |
| العلاقة: | https://iimmun.ru/iimm/article/viewFile/1961/1503Test; https://doaj.org/toc/2220-7619Test; https://doaj.org/toc/2313-7398Test |
| DOI: | 10.15789/2220-7619-CCO-1961 |
| الوصول الحر: | https://doaj.org/article/101d4bb2a3c64655af021007c79547a1Test |
| رقم الانضمام: | edsdoj.101d4bb2a3c64655af021007c79547a1 |
| قاعدة البيانات: | Directory of Open Access Journals |
| تدمد: | 22207619 23137398 |
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| DOI: | 10.15789/2220-7619-CCO-1961 |