DOI: http://dx.doi.org/10.18203/2349-2902.isj20213636

Extensive post-covid mucormycosis salvaged by old fashioned negative pressure wound therapy

R. Sanjay, Farukh Khan, Shalu Gupta, Rahul Chikkarangappa, Komal Choudhary

Abstract


Mucormycosis represents a group of life threatenening infections caused by fungi of the order Mucorales. Mucorales are ubiquitous environmental fungi that grow well in moist and damp conditions. They can invade arteries to cause thrombosis and infarction. These fungi cause infection primarily in patients with diabetes, neutropenia, elevated levels of free iron and those who are on glucocorticoid therapy, which supports fungal growth in serum and tissues. Recently the incidence of mucormycosis was found to have increased in patients previously infected with coronavirus (COVID-19). Here we presented a 52 year old lady who was previously infected by coronavirus, was administered glucocorticoids as a part of empirical treatment for COVID-19 pnemonitis. She recovered uneventfully within a few days, but, around a month later presented with erythematous papule over the anterior chest wall. The papule developed into a large fungating ulcer over a period of 10 days. KOH mount and culture confirmed it to be mucormycosis. Cutaneous mucormycosis can be highly invasive, penetrating into muscle, fascia and even bone. These are molds that grow well in moist and damp conditions. But depriving them of moisture and oxygen can help control their spread. This could be achieved by thorough debridement and applying negative pressure to the wound. The results achieved are remarkable and satisfactory.


Keywords


Post-covid mucormycosis, Negative pressure wound therapy, Anterior chest wall mucormycosis

Full Text:

PDF

References


Spellberg B, Ibrahim AS. Harrison’s Principles of Internal Medicine. 20th ed. New York: McGraw Hill; 2018.

Spellberg B, Edwards J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation and management. Clin Microbiol Rev. 2005;18(3):556-69.

Kanungo R. Ananthanarayan and Paniker’s Textbook of Microbiology. 10th ed. The Orient Blackswan; 2017.

Slavin M, VanHal S, Sorrell T, Lee A, Marriott D, Daveson K, et al. Invasive infections due to filamentous fungi other than Aspergillus: epidemiology and determinants of mortality. Clin Microbiol Infect. 2015;21(5):490.

Williams NS, O'Connell PR, McCaskie A. Bailey and Love Short Practice of Surgery. 27th ed. United Kingdom: CRC Press; 2018.

Murray PR, Baron EJ. Manual of Clinical Microbiology. 9th ed. Washington: ASM press; 2007.

Robson MC, Steed DL, Franz MG. Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg. 2001;38(2):72-140.

Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38(6):563-77.