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Invasive Fusarium Rhinosinusitis in Covid-19 Patients: Report of Three Cases With Successful Management Publisher Pubmed



Erami M1 ; Aboutalebian S2, 3 ; Hashemi Hezaveh SJ4 ; Matini AH5 ; Momenheravi M6 ; Ahsaniarani AH7 ; Arani SS5 ; Ganjizadeh M1 ; Mirhendi H2, 3
Authors
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Authors Affiliations
  1. 1. Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
  2. 2. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Pathology and Histology, School of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
  6. 6. Department of Infectious Disease, 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: Frontiers in Cellular and Infection Microbiology Published:2023


Abstract

Invasive fungal rhinosinusitis (IFRS) is a life-threatening infection that can occur in immunocompromised patients, including those with COVID-19. Although Mucorales and Aspergillus species are the most common causes of IFRS, infections caused by other fungi such as Fusarium are rare. In this report, we present three cases of proven rhinosinusitis fusariosis that occurred during or after COVID-19 infection. The diagnosis was confirmed through microscopy, pathology, and culture, and species identification of the isolates was performed by DNA sequencing the entire ITS1-5.8 rRNA-ITS2 region and translation elongation factor 1-alpha (TEF-1α). Antifungal susceptibility testing was conducted according to CLSI guidelines. The causative agents were identified as Fusarium proliferatum, F. oxysporum + Aspergillus flavus, and F. solani/falciforme. Treatment involved the administration of antifungal medication and endoscopic sinus surgery to remove the affected mucosa, leading to the successful resolution of the infections. However, one patient experienced a recurrence of IFRS caused by A. flavus 15 months later. Early diagnosis and timely medical and surgical treatment are crucial in reducing mortality rates associated with invasive fusariosis. Additionally, the cautious use of corticosteroids in COVID-19 patients is highly recommended. Copyright © 2023 Erami, Aboutalebian, Hashemi Hezaveh, Matini, Momen-Heravi, Ahsaniarani, Arani, Ganjizadeh and Mirhendi.
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