Mixed etiology COVID-19 associated acute rhinosinusitis caused by two Aspergillus species. (March 2022)

• Record Type: Journal Article
• Authors: Tabarsi, Payam; Sharifynia, Somayeh; Pourabdollah Toutkaboni, Mihan; Abtahian, Zahra; Rahdar, Mohammad; Sadat Mirahmadian, Arefeh; Hakamifard, Atousa
• Is Part Of: Annals of medicine and surgery. Volume 75(2022)
• Publication Date: 2022-03
• Subjects: Aspergillosis -- Fungal infections -- Aspergillus -- rhino‐sinusitis -- SARS-CoV-2 -- Aspergillus flavus -- Aspergillus niger; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103365
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Acute invasive fungal rhino‐sinusitis (AIFR) is a life-threatening infection that is mostly found in immunocompromised patients with serious morbidity and mortality. Recently, reports of AIFR have also emerged among SARS-CoV-2 infected patients. Case presentation: A 50-year-old diabetic woman, previously diagnosed with COVID-19 pneumonia, was presented to the hospital with left facial pain on day 12 after discharge. Paranasal sinuses computed tomography was performed and according to the mucosal thickening in both maxillary sinuses and ethmoidal air cells, the patient underwent functional endoscopic sinus surgery (FESS) and necrosis were observed. The histopathologic examination revealed mycelium with septation suspected to Aspergillus and the culture was consistent with Aspergillus flavus and also Aspergillus niger . We reported a case of COVID-19 associated AIFR with two combined Aspergillus species from Iran. The patient received liposomal amphotericin B, which then switched to voriconazole combined with aggressive surgical debridement of necrotic tissues with a clinically favorable outcome. Conclusion: Mixed etiology AIFR can influence the outcome. However, further investigation is required upon this new threat. Highlights: Acute invasive fungal rhino‐sinusitis (AIFR) is a life threatening infection mostly found in immunocompromised patients. Reports of AIFR have emerged among SARS-CoV-2 infected patients. Mixed etiology AIFR can also influence the outcome and further studies are required upon this new threat.