Mucormycosis in covid diabetic patients: A horrifying triad!

Abstract

Infectious diseases with the coronavirus disease 2019 (COVID-19) can be linked to various microbial and fungal coinfections. Mucormycosis is an invasive opportunistic infection that enters as inhalation of fungal spores through the nose or paranasal sinuses in diabetic and immunocompromised patients. We present our experience of managing seven cases of recent COVID-19 infection with uncontrolled diabetes who developed rhino-orbital mucormycosis. All patients were diagnosed by clinical examination and imaging and managed by emergency surgical debridement and liposomal amphotericin-B. A lethal triad of impaired immunity due to COVID-19 infection, state of hyperglycemia, increased use of steroids, or rampant broad-spectrum antimicrobials works as fertile soil and may assist in the growth or alleviation of a fungal infection. Healthcare professionals must be aware of the potential of secondary invasive fungal infections in diabetic patients with moderate to severe category of COVID-19 infectious disease, especially on steroid therapy.