Rise of the Phoenix: Mucormycosis in the Context of COVID-19

Opportunistic infections are especially common in patients who, apart from the current COVID-19 disease, also have other comorbidities such as diabetes, prolonged stay in intensive care unit, treatment with mechanical ventilation, antibiotic therapy and prolonged use of corticosteroids. Mucormycosis, for example, is an acute or sub acute rapidly progressing infections caused by the angioinvasive fungi in the order of Mucorales such as species of Rhizopus, Mucor, Rhizomucor, Syncephalastrum, Cunninghamella, Apophysomyces and Lichtheimia. This infection is characterized by vascular invasion by the fungal hyphae which leads to thrombosis and necrosis. To diagnose the suspicion of mucormycosis, an extensive analysis of the patient's history associated with physical and imaging examination is very important. Biopsy, culture in specific media and polymerase chain reaction (PCR) of clinical specimens can be used to identify the fungus agent of mucormycosis. The widely accepted treatment of choice for mucormycosisis amphotericin B. In addition to early detection of the fungus, the correction of pre-existing pathologies (such as diabetes, immunosuppression and inflammation) is of great importance to ensure therapeutic success. Thus, given this scenario, it is imperative that clinicians should be sensitized to the increased risk of development of this fatal infection, especially while treating diabetic patients with COVID-19, using corticosteroids.