A case of COVID‐19‐associated mucormycosis due to Lichtheimia ramosa

• Published in: Journal of clinical laboratory analysis Vol. 37; no. 8; pp. e24895 - n/a
• Main Authors: Aboutalebian, Shima, Erami, Mahzad, Momen‐Heravi, Mansooreh, Charsizadeh, Arezoo, Hezaveh, Seyed Jamal Hashemi, Matini, Amir Hassan, Ahsaniarani, Amir Hossein, Fakhrehi, Mojtaba, Mirhendi, Hossein
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.04.2023; John Wiley and Sons Inc
• Subjects: Aged; Amphotericin B; Antibiotics; Antifungal Agents; Case Report; Computed tomography; Corticosteroids; COVID-19; COVID-19 - complications; Cytokines; Diabetes; Diabetes mellitus; Disease; Endoscopy; Epidemics; Female; Fungal infections; Fungi; Hematology; Humans; Hyperglycemia; Laboratories; Lichtheimia ramosa; Medical imaging; Morphology; Mortality; Mucorales; Mucormycosis; Mucormycosis - complications; Mucormycosis - diagnosis; Mucormycosis - microbiology; Neutrophils; Paranasal sinus; Patients; Pneumonia; Rhinitis; rhinosinusitis; Ribosomal DNA; Severe acute respiratory syndrome coronavirus 2; Sinuses; Sinusitis; Steroids; Tomography; Viral infections; COVID-19; Lichtheimia ramosa; rhinosinusitis; diabetes; mucormycosis
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.24895

Background Mucormycosis is a life‐threatening invasive fungal infection in immunocompromised and COVID‐19 patients. Case Report Here, we report a fatal rhino‐orbito‐cerebral mucormycosis caused by Lichtheimia ramosa, in a 79‐year‐old diabetic female. She was initially admitted to the hospital for COVID‐19 infection and received broad‐spectrum antibiotics and corticosteroids. After 1 month, she was admitted again because of persistent headaches and decreased right eye movement when the computed tomography scan showed mucosal thickening and opacification of paranasal sinuses. Microbiological investigations, including culture and direct microscopy, and histopathological findings confirmed the diagnosis of proven mucormycosis. The isolated causal agent was identified as Lichtheimia ramosa by sequencing the entire ITS region of nuclear ribosomal DNA. Despite surgical debridement and administration of liposomal amphotericin B 5 mg/kg/day, the patient's level of consciousness suddenly deteriorated; she was intubated and mechanically ventilated in the ICU and died on the same day. Conclusion To our knowledge, this is the first worldwide case of COVID‐19‐associated rhino‐orbito‐cerebral mucormycosis due to Lichtheimia ramosa.