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A Case of Covid-19-Associated Mucormycosis Due to Lichtheimia Ramosa Publisher Pubmed



Aboutalebian S1, 2 ; Erami M3, 4 ; Momenheravi M3 ; Charsizadeh A5 ; Hezaveh SJH4 ; Matini AH6 ; Ahsaniarani AH7 ; Fakhrehi M3 ; Mirhendi H1, 2
Authors
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Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Infectious Disease, School of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
  4. 4. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Pathology and Histology, School of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
  7. 7. Department of Otorhinolaryngology, School of Medicine, Matini Hospital, Kashan University of Medical Sciences, Kashan, Iran

Source: Journal of Clinical Laboratory Analysis Published:2023


Abstract

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. © 2023 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.
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