POST-COVID-19 PULMONARY ASPERGILLOSIS AND MUCORMYCOSIS CO-INFECTION IN A PATIENT WITH DIABETES: A COMBINED CHALLENGING COMPLICATION

Abstract

TYPE: Abstract TOPIC: Chest Infections PURPOSE: The recent emergence of COVID-19 disease had been associated with rare, invasive and life threatening fungal infections such as pulmonary aspergillosis and mucormycosis caused by Aspergillus fumigatus and Rhizopus arrhizus respectively with higher case fatality rate(>50%) especially among immunocompromised patients, diabetes mellitus, usage of steroids & other immunomodulators and covid infection itself. Here,we describe a case of Pulmonary aspergillosis and mucormycosis occuring in a 62 years old male diabetic patient who had history of COVID-19 infection 42 days back. After confirmation of diagnosis and aggressive therapeutic measures, he was discharged after 6 weeks of indoor treatment. The treatment depends on early and precise diagnosis followed by long term use of combination of antifungal agents and surgical intervention when necessary. Thus careful assessment and early diagnosis could lead to early therapeutic interventions and ultimately better outcomes. METHODS: Diagnosis on the basis of imaging CT Thorax findings- 52*48 mm thick walled cavity lesion with surrounding area of consolidation- reverse halo sign in right lower lobe and bronchoscopy guided TBLB & HPE findings were positive for aspergillus and mucormycosis. RESULTS: Both bronchoscopic and TBLB are effective tools to diagnose aspergillus and mucomycosis infection.In the treatment part, if feasible, attempts to reverse the underlying predisposing factors should be made. CONCLUSIONS: This case report highlights the need for healthcare professionals to be aware that combined pulmonary aspergillosis and mucormycosis can present as secondary complications of COVID-19 coinfection in diabetics. CLINICAL IMPLICATIONS: The combined risk factors of diabetes mellitus, COVID-19 and recent corticosteroid treatment contributed to both infections in our patient. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19 , Pulmonary , Aspergillosis , Mucormycosis , Diabetes mellitus