Mucormicosis asociada a la COVID-19 en Venezuela: consideraciones en torno a un caso y revisión de la literatura.

Abstract

Abstract. Mucormycosis is an emerging, severe, opportunistic, invasive mycosis with a worldwide distribution, low frequency, and high morbidity and mortality linked to immunodeficiency conditions. A significant increase in COVID-19-associated mucormycosis (CAM) has occurred in countries such as India and several countries of the Americas. We describe the presentation and management of a CAM case and discuss the clinical and public health sig-nificance of its characteristics concerning CAM and non-CAM cases reported in the literature. Using a timeline, epidemiological, clinical, microbiological, histopathological, imaging features, and multidisciplinary interventions in this CAM case are presented. A 64-year-old male patient from the north cen-ter of Venezuela, with a history of diabetes mellitus and a home-cared mod-erate COVID-19 episode treated on an outpatient basis, presented with left unilateral rhino-sinus-orbital mucormycosis with dentomaxillary extension. His first symptoms and signs were sinusitis, palatal changes, maxillary region pain, and loosening of teeth 19 days after the COVID-19 diagnosis. Mycologi-cal diagnosis supported by histopathology, direct examination, and culture indicated a Rhizopus spp. infection. The patient was successfully treated with amphotericin B, surgery with an endoscopic approach, and metabolic control. We discuss the influence of COVID-19 and its management regarding CAM development, as well as the importance of access to healthcare in this situa-tion. Mucormycosis should be considered among potential complications in diabetic patients with COVID-19. Therefore, comprehensive care and moni-toring must be provided in all phases of the COVID-19 clinical picture.