By NewsDesk @infectiousdiseasenews
The Ministry of Health of the Nation informs that the first notification was received to the National Health Surveillance System ((SNVS-SISA) of a case of mucormycosis, known as “black fungus”, associated with a patient from Formosa who had COVID -19 In addition, another probable case of mucormycosis, also associated with COVID, is being investigated in a deceased person living in the province of Buenos Aires.
For this reason, and within the framework of the Alert issued this week by the Pan American Health Organization, the Ministry issued a Communication to health teams with the purpose of strengthening capacities to suspect the disease in patients with COVID-19 -especially those with diabetes mellitus, treatment with corticosteroids or other immunosuppressants, make an early diagnosis, start appropriate treatment and report cases according to current regulations.
The case registered in the province of Formosa, which was reported through the National Health Surveillance System, is a 47-year-old woman with a history of high blood pressure, type II diabetes mellitus and COVID-19 with onset of symptoms on May 11, an illness that passed through an isolation center.
After being discharged for COVID, the person had a headache and impaired sensorium, for which he consults an otolaryngology clinic for a palate lesion. After the pertinent examinations, on June 9 she was admitted for a surgical toilette and a sample was taken for microbiological diagnosis in the Mycology laboratory of the Hospital de Alta Complejidad de Formosa where coenocytic hyphae compatible with mucoral are reported.
Specific antifungal treatment and surgical cleaning of the affected area were immediately started and on June 12 the diagnosis of mucormycosis was confirmed by isolation and micromorphological identification of Rhizopus sp.
Currently the patient is being treated with liposomal amphotericin and surgical interventions, with a reserved prognosis.
On the other hand, another probable case of Mucormycosis was also notified to the National Directorate of Epidemiology, in a deceased person residing in the province of Buenos Aires who is currently under investigation.
Mucormycosis is a severe, rapidly progressive angioinvasive disease that is very rare in the general population. The fatality rate is estimated at 40-80%. In the current context of the coronavirus pandemic, COVID-19 can present as mild to life-threatening pneumonia, with opportunistic co-infections caused by different bacteria and fungi, including mucormycosis.
Mucormycosis is characterized by infarction and necrosis of host tissues, resulting from invasion of vessels by hyphae. The clinical presentations of mucormycosis can be: rhino-orbito-cerebral, pulmonary, cutaneous, gastrointestinal and disseminated.
Signs and symptoms may include: fever, pain, inflammation and redness of the affected area, appearance of necrotic scabs or scabs, proptosis, compromise of vision and sensory, orbital cellulitis, ophthalmoplegia, sinusitis, purulent rhinorrhea, ulcers in palate. If the location is pulmonary, there may be respiratory distress, cough, hemoptysis, and pleural pain.
Rapidly progressive, patient recovery depends on how quickly specific antifungal treatment (Amphotericin B) is diagnosed and initiated, and in many cases surgical resection of necrotic tissue is necessary, which may include bone and ocular tissue.