scholarly journals Autopsy dissection techniques and investigations in deaths due to COVID-19 triggered fungal infections - A diagnostic review

2021 ◽  
Vol 8 (4) ◽  
pp. 207-213
Author(s):  
Himanshi Narang ◽  
Amit Patil
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Fungal Infections ◽  
Invasive Disease ◽  
Invasive Fungal Infections ◽  
Correct Interpretation ◽  
Research Papers ◽  
Dissection Techniques ◽  
Second Wave

The COVID-19 pandemic, which originated from Wuhan, China, has rapidly spread worldwide, including India. As India grappled with the second wave, COVID-triggered fungal infection has suddenly risen tremendously, raising a sense of panic in the country. The fungal infection in COVID-19 includes Mucormycosis and Aspergillosis, as common fungal infections primarily affecting rhino-orbital structures. Many research papers have published postmortem findings in autopsies conducted on COVID-19 decedents, thereby helping to understand this contagious disease's pathogenesis. But, with the arrival of COVID-triggered fungal infection, which is a crucial invasive disease responsible for fatality, very few research papers have commented on the postmortem findings of invasive fungal infections affecting the rhino-orbital and craniocerebral structures in COVID-19 deaths. Therefore, the role of invasive fungal infection due to COVID-19 illness must be established in the causation of deaths in COVID-19 patients. This review research deals with autopsy dissection techniques and possible postmortem findings of invasive fungal infections involving the nasal and paranasal sinuses and orbital structures in COVID-19 deaths. The findings of fungal infection affecting nasal and paranasal systems may not differ in live patients and in a deceased; however, it is essential that correct interpretation of the postmortem findings aided by pre-or post-autopsy investigations is necessary to establish the role of covid triggered fungal infection in such deaths.

scholarly journals Black fungus due to covid-19: audiological assessment of middle ear functioning

2021 ◽  
Author(s):  
Prajwal Kumar ◽  
Swati Goyal ◽  
Prashanth Prabhu
Keyword(s):  
Early Detection ◽  
Fungal Infection ◽  
Middle Ear ◽  
Paranasal Sinuses ◽  
Crucial Role ◽  
Otoacoustic Emissions ◽  
Easy Access ◽  
Study Results ◽  
Second Wave

Background and Aim: A rare fungal infection, mucormycosis, has become more common in patients recovering from COVID in its second wave in India. The proximity and easy access to the middle ear through the Eustachian tube from paranasal sinuses alarms the need for early detec­tion of middle ear involvement. Hence, the study was carried out to determine the influence of mucormycosis on Immittance and otoacoustic emissions. Methods: eleven rhino orbital mucormycosis patients aged 40-60 years participated in the study. Middle ear evaluation was carried out with the help of Immittance and otoacoustic emissi­ons. Results: It was found that 4/11 (36.36%) parti­cipants had abnormal Immittance and absent oto­acoustic emissions, indicating middle ear dys­function. 3/4 participants had middle ear dys­function in the ear ipsilateral to the side of the infection. Conclusion: The study results reveal a rare cha­nce of middle ear involvement in mucormycosis patients, which calls for the crucial role of the audiologist in the early detection of middle ear dysfunction. Keywords: Mucormycosis; immittance; otoacoustic emissions

The role of complement in invasive fungal infections. Die Rolle des Komplements bei invasiven Pilzinfektionen

Mycoses ◽  
2004 ◽  
Vol 47 (3-4) ◽  
pp. 93-103 ◽  
Author(s):  
Cornelia Speth ◽  
Gunter Rambach ◽  
Cornelia Lass-Florl ◽  
Manfred P. Dierich ◽  
Reinhard Wurzner
Keyword(s):  
Fungal Infections ◽  
Invasive Fungal Infections

Identification and in Vitro Susceptibility Pattern of Fungal Pathogens in Immunocompromised Patients with invasive Fungal Infections

2021 ◽  
Vol 30 (3) ◽  
pp. 127-134
Author(s):  
Shaimaa A.S. Selem ◽  
Neveen A. Hassan ◽  
Mohamed Z. Abd El-Rahman ◽  
Doaa M. Abd El-Kareem
Keyword(s):  
Intensive Care ◽  
Fungal Infection ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Antifungal Susceptibility ◽  
Invasive Fungal Infections ◽  
Immunocompromised Patients ◽  
University Hospitals ◽  
Vitek 2

Background: In intensive care units, invasive fungal infections have become more common, particularly among immunocompromised patients. Early identification and starting the treatment of those patients with antifungal therapy is critical for preventing unnecessary use of toxic antifungal agents. Objective: The aim of this research is to determine which common fungi cause invasive fungal infection in immunocompromised patients, as well as their antifungal susceptibility patterns in vitro, in Assiut University Hospitals. Methodology: This was a hospital based descriptive study conducted on 120 patients with clinical suspicion of having fungal infections admitted at different Intensive Care Units (ICUs) at Assiut University Hospitals. Direct microscopic examination and inoculation on Sabouraud Dextrose Agar (SDA) were performed on the collected specimens. Isolated yeasts were classified using phenotypic methods such as chromogenic media (Brilliance Candida agar), germ tube examination, and the Vitek 2 system for certain isolates, while the identification of mould isolates was primarily based on macroscopic and microscopic characteristics. Moulds were tested in vitro for antifungal susceptibility using the disc diffusion, and yeast were tested using Vitek 2 device cards. Results: In this study, 100 out of 120 (83.3%) of the samples were positive for fungal infection. Candida and Aspergillus species were the most commonly isolated fungal pathogens. The isolates had the highest sensitivity to Amphotericin B (95 %), followed by Micafungin (94 %) in an in vitro sensitivity survey. Conclusion: Invasive fungal infections are a leading cause of morbidity and mortality in immunocompromised patients, with Candida albicans being the most frequently isolated yeast from various clinical specimens; however, the rise in resistance, especially to azoles, is a major concern.

scholarly journals Isavuconazole—Animal Data and Clinical Data

2020 ◽  
Vol 6 (4) ◽  
pp. 209
Author(s):  
Livio Pagano ◽  
Chiara Cattaneo ◽  
Martina Quattrone ◽  
Margherita Oberti ◽  
Maria Mazzitelli ◽  
...  
Keyword(s):  
Clinical Data ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Hematological Patients ◽  
Animal Data

The treatment of invasive fungal infections has deeply evolved in the last years with the inclusion of new antifungals, mainly new azoles (i.e., posaconazole, isavuconazole), to the therapeutic armamentarium. This review focuses on the role of isavuconazole for treating the most important invasive fungal infections both in animals and humans (hematological and non-hematological patients).

Outcomes of invasive fungal infections in hematopoietic stem cell transplant patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18008-e18008
Author(s):  
Shagufta Shaheen ◽  
Shivanck Upadhyay ◽  
Creticus Petrov Marak ◽  
Gagan Kumar ◽  
Achuta Kumar Guddati
Keyword(s):  
Stem Cell ◽  
Fungal Infection ◽  
Hospital Stay ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Length Of Hospital Stay ◽  
Invasive Fungal Infections ◽  
Cell Transplant ◽  
Hematopoietic Stem

e18008 Background: Invasive fungal infections are associated with higher mortality in hematopoietic stem cell transplant (HSCT) recipients despite the use of broad spectrum antifungal agents. With the increase in the number of patients undergoing HSCT and a newer array of immunosuppressants, it is necessary to examine the incidence and outcomes of fungal infection in this population. Methods: We used Nationwide Inpatient Sample from years 2000 to 2008 to examine the trends and outcomes of fungal infections in patients admitted for HSCT. We used ICD-9-CM codes to identify those with HSCT. Similarly we identified invasive fungal infection using ICD-9-CM codes. The engraftment period and subsequent admissions were examined separately. Outcomes studied were in-hospital mortality and length of hospital stay. Logistic regression analysis was used to identify independent association of fungal infection with mortality. The model was adjusted for demographic and hospital characteristics, Charlson's co-morbidity index and severity of sepsis using number of organ failures. Results: There were 291,182 admissions with HSCT from 2000 to 2008. Of these, 3.4% patients had invasive fungal infections. They were more frequent in allogenic transplant during the engraftment period (4.2%) and in those with graft versus host disease (GVHD) in subsequent admission (7.1%). The unadjusted in-hospital mortality was significantly higher in those with invasive fungal infection (28% vs. 7%, p<0.001). On adjusted analysis, the odds of mortality were highest for those with mucor (OR 4.3;95%CI 2.5-7.5) and aspergillus (OR 3.7; 95%CI 3.1-4.5) infections while the results did not reach significance for candidemia. The length of hospital stay was significantly longer in those with invasive fungal infections (median 19 days vs. 7 days, p<0.001). Conclusions: Fungal infections are common in HSCT recipients - especially in those with allografts and with GVHD. Mortality is high and is mostly associated with aspergillus and mucor. A higher index of suspicion for fungal infections in HSCT patients, strict isolation precautions and increased surveillance for aspergillus and mucor in HSCT patients may help decrease the length of hospital stay and mortality.

scholarly journals COVID 19 ASSOCIATED INVASIVE FUNGAL INFECTIONS IN CHURU REGION OF RAJASTHAN

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Vikas Devra ◽  
Varsha Varshney
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Global Pandemic ◽  
Significant Incidence ◽  
Mri Scans ◽  
Reduction Of Mortality

Background: COVID 19 or severe acute respiratory syndrome (SARS-CoV-2) evolved as global pandemic since December 2019 when it was first reported in Wuhan, China. Coinfection in patients with COVID-19 has been reported in multiple studies, being bacterial in origin the most frequent; and fungal infection being reported only in severe cases. Methods: This study was conducted at the department of E.N.T. at PanditDeenDayalUpadhyay Medical College, Churu. Cases presented to E.N.T. OPD with clinical features of invasive rhino-orbital fungal infection for the period of two month from 1st June 2021 were included in the study. Patients were clinically evaluated, HRCT, MRI scans and with KOH mount and culture of involved tissue ere done. Patient’s COVID-19 status was ascertained. The clinicopathological association of occurrence of invasive fungal infections in post covid and non-covid patients along with other risk factors like diabetes mellitus, immune compromised state and long-term steroid use was done using statistical methods Results: We studied 21 patients who attended our OPD with features of invasive fungal infection. Most common presentation was swelling and pain in the cheek region and red eye and swelling around the eye, three patients presented with maxillary swelling with blackish discoloration of teeth. Radiological findings were suggestive of fungal etiology in all patients. KOH mount showed fungal hyphae in 20 cases. Total 20 cases were post COVID status. Old DM was there in 12 patients whereas 9 patients showed new onset hyperglycemia. Conclusions: COVID-19 is associated with a significant incidence of secondary infections, both bacterial and fungal probably due to immune dysregulation. The widespread use of steroids/monoclonal antibodies/broad-spectrum antibiotics as part of the management protocols against COVID-19 may lead to the exacerbation of preexisting fungal diseases or development of new infection. Treating Physicians should make themselves aware and prepare for the possibility of invasive secondary fungal infections in patients with COVID-19 infection especially in patients with preexisting risk factors and should enable early diagnosis and treatment with the subsequent reduction of mortality and morbidity. Keywords: Coronavirus, COVID-19, mucormycosis, invasive fungal infections

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