Case report: Disseminated mucormycosis misdiagnosed as malignancy developed from allergic bronchopulmonary mycosis caused by Rhizopus microsporus following SARS-CoV-2 infection in a woman

被引:1
作者
Kong, Chengying [1 ]
Zong, Laibin [2 ]
Ji, Shunxian [3 ]
Liu, Yangxiang [1 ]
Li, Miaomiao [1 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 4, Sch Med, Dept Resp & Crit Care Med, Yiwu, Zhejiang, Peoples R China
[2] Zhejiang Univ, Affiliated Hosp 4, Sch Med, Dept Clin Lab, Yiwu, Zhejiang, Peoples R China
[3] Zhejiang Univ, Affiliated Hosp 4, Sch Med, Dept Pathol, Yiwu, Zhejiang, Peoples R China
关键词
mucormycosis; pulmonary mucormycosis; Rhizopus spp; allergic bronchopulmonary mycosis (ABPM); SARS-CoV-2; case report; PULMONARY MUCORMYCOSIS;
D O I
10.3389/fmed.2024.1394500
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Mucormycosis has become more prevalent during the COVID-19 pandemic and is associated with a high mortality rate. However, concurrent host allergic reactions, invasive pulmonary mucormycosis, and disseminated mucormycosis are rarely reported. Herein, we describe a case of disseminated mucormycosis initially misdiagnosed as a malignancy that developed from allergic bronchopulmonary mycosis caused by Rhizopus microsporus in a woman with post-SARS-CoV-2 infection. The previously healthy patient presented with a sizeable mass in the right middle lobe and multiple lesions across the lungs, brain, spleen, kidneys, pancreas, and subcutaneous tissue 6 months after SARS-CoV-2 infection, mimicking an extensive metastatic malignancy. Eosinophilia, elevated total plasma immunoglobulin E, and significant eosinophilic lung tissue infiltration were observed. Rhizopus microsporus was isolated from subcutaneous tissue, and hyphae were detected in the lung tissue. Sequential amphotericin B liposomes followed by isavuconazole antifungal therapy combined with systemic corticosteroids improved symptoms, significantly reduced the sizes of pulmonary lesions, and reduced eosinophil count. However, it failed to halt the overall progression of the disease, and the patient died. The absence of asthma-like symptoms and delayed recognition of invasive fungal infection signs contributed to poorer outcomes, highlighting the need for a thorough post-COVID-19 follow-up.
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共 13 条
[1]   Allergic bronchopulmonary mycosis due to fungi other than Aspergillus: a global overview [J].
Chowdhary, Anuradha ;
Agarwal, Kshitij ;
Kathuria, Shallu ;
Gaur, Shailendra Nath ;
Randhawa, Harbans Singh ;
Meis, Jacques F. .
CRITICAL REVIEWS IN MICROBIOLOGY, 2014, 40 (01) :30-48
[2]   Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium [J].
Cornely, Oliver A. ;
Alastruey-Izquierdo, Ana ;
Arenz, Dorothee ;
Chen, Sharon C. A. ;
Dannaoui, Eric ;
Hochhegger, Bruno ;
Hoenigl, Martin ;
Jensen, Henrik E. ;
Lagrou, Katrien ;
Lewis, Russell E. ;
Mellinghoff, Sibylle C. ;
Mer, Mervyn ;
Pana, Zoi D. ;
Seidel, Danila ;
Sheppard, Donald C. ;
Wahba, Roger ;
Akova, Murat ;
Alanio, Alexandre ;
Al-Hatmi, Abdullah M. S. ;
Arikan-Akdagli, Sevtap ;
Badali, Hamid ;
Ben-Ami, Ronen ;
Bonifaz, Alexandro ;
Bretagne, Stephane ;
Castagnola, Elio ;
Chayakulkeeree, Methee ;
Colombo, Arnaldo L. ;
Corzo-Leon, Dora E. ;
Drgona, Lubos ;
Groll, Andreas H. ;
Guinea, Jesus ;
Heussel, Claus-Peter ;
Ibrahim, Ashraf S. ;
Kanj, Souha S. ;
Klimko, Nikolay ;
Lackner, Michaela ;
Lamoth, Frederic ;
Lanternier, Fanny ;
Lass-Floerl, Cornelia ;
Lee, Dong-Gun ;
Lehrnbecher, Thomas ;
Lmimouni, Badre E. ;
Mares, Mihai ;
Maschmeyer, Georg ;
Meis, Jacques F. ;
Meletiadis, Joseph ;
Morrissey, C. Orla ;
Nucci, Marcio ;
Oladele, Rita ;
Pagano, Livio .
LANCET INFECTIOUS DISEASES, 2019, 19 (12) :E405-E421
[3]   The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries [J].
Hoenigl, Martin ;
Seidel, Danila ;
Carvalho, Agostinho ;
Rudramurthy, Shivaprakash M. ;
Arastehfar, Amir ;
Gangneux, Jean-Pierre ;
Nasir, Nosheen ;
Bonifaz, Alexandro ;
Araiza, Javier ;
Klimko, Nikolai ;
Serris, Alexandra ;
Lagrou, Katrien ;
Meis, Jacques F. ;
Cornely, Oliver A. ;
Perfect, John R. ;
White, P. Lewis ;
Chakrabarti, Arunaloke .
LANCET MICROBE, 2022, 3 (07) :E543-E552
[4]   Host-Pathogen Molecular Factors Contribute to the Pathogenesis of Rhizopus spp. in Diabetes Mellitus [J].
Morales-Franco, Berenice ;
Nava-Villalba, Mario ;
Medina-Guerrero, Edgar Octavio ;
Sanchez-Nuno, Yair Adonai ;
Davila-Villa, Perla ;
Anaya-Ambriz, Elsa Janneth ;
Charles-Nino, Claudia Lisette .
CURRENT TROPICAL MEDICINE REPORTS, 2021, 8 (01) :6-17
[5]   Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India [J].
Muthu, Valliappan ;
Agarwal, Ritesh ;
Patel, Atul ;
Kathirvel, Soundappan ;
Abraham, Ooriapadickal Cherian ;
Aggarwal, Ashutosh Nath ;
Bal, Amanjit ;
Bhalla, Ashu Seith ;
Chhajed, Prashant N. ;
Chaudhry, Dhruva ;
Garg, Mandeep ;
Guleria, Randeep ;
Krishnan, Ram Gopal ;
Kumar, Arvind ;
Maheshwari, Uma ;
Mehta, Ravindra ;
Mohan, Anant ;
Nath, Alok ;
Patel, Dharmesh ;
Rudramurthy, Shivaprakash Mandya ;
Saxena, Puneet ;
Sethuraman, Nandini ;
Singhal, Tanu ;
Soman, Rajeev ;
Thangakunam, Balamugesh ;
Varghese, George M. ;
Chakrabarti, Arunaloke .
LANCET INFECTIOUS DISEASES, 2022, 22 (09) :E240-E253
[6]   Global Epidemiology of Mucormycosis [J].
Prakash, Hariprasath ;
Chakrabarti, Arunaloke .
JOURNAL OF FUNGI, 2019, 5 (01)
[7]   Zygomycetes in human disease [J].
Ribes, JA ;
Vanover-Sams, CL ;
Baker, DJ .
CLINICAL MICROBIOLOGY REVIEWS, 2000, 13 (02) :236-+
[8]   SARS-CoV-2 infection induces the dedifferentiation of multiciliated cells and impairs mucociliary clearance [J].
Robinot, Remy ;
Hubert, Mathieu ;
de Melo, Guilherme Dias ;
Lazarini, Francoise ;
Bruel, Timothee ;
Smith, Nikaia ;
Levallois, Sylvain ;
Larrous, Florence ;
Fernandes, Julien ;
Gellenoncourt, Stacy ;
Rigaud, Stephane ;
Gorgette, Olivier ;
Thouvenot, Catherine ;
Trebeau, Celine ;
Mallet, Adeline ;
Dumenil, Guillaume ;
Gobaa, Samy ;
Etournay, Raphael ;
Lledo, Pierre-Marie ;
Lecuit, Marc ;
Bourhy, Herve ;
Duffy, Darragh ;
Michel, Vincent ;
Schwartz, Olivier ;
Chakrabarti, Lisa A. .
NATURE COMMUNICATIONS, 2021, 12 (01)
[9]   Epidemiology and outcome of zygomycosis: A review of 929 reported cases [J].
Roden, MM ;
Zaoutis, TE ;
Buchanan, WL ;
Knudsen, TA ;
Sarkisova, TA ;
Schaufele, RL ;
Sein, M ;
Sein, T ;
Chiou, CC ;
Chu, JH ;
Kontoyiannis, DP ;
Walsh, TJ .
CLINICAL INFECTIOUS DISEASES, 2005, 41 (05) :634-653
[10]   The spectrum of allergic fungal diseases of the upper and lower airways [J].
Rodrigues, Jonathan ;
Caruthers, Carrie ;
Azmeh, Roua ;
Dykewicz, Mark S. ;
Slavin, Raymond G. ;
Knutsen, Alan P. .
EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2016, 12 (05) :531-550