'Mucormycosis' A Fungal Infection Threatening India During COVID-19' - A Review

2021 ◽  
Vol 19 ◽  
Author(s):  
Sumel Ashique
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Invasive Pulmonary Aspergillosis ◽  
Background Risk ◽  
Pulmonary Aspergillosis ◽  
Second Wave

: During the second wave of Covid-19 in India, doctors recently reported a outbreak of cases involving a rare infection - called the "black fungus" - among recovering and recovered Covid-19 patients. The frequency of bacterial and fungal coinfections has been continuously rising. At the same time, invasive pulmonary aspergillosis is increasingly being recognized in association with nCOVID-19. Currently, India is suffering from a newly maiming disease associated with nCOVID-19 infected patients; at the time of the treatment, it can be developed into rhino-orbital mucormycosis. There are some approved antifungal therapies for treating this fungal infection. The background, risk factors, and associated reports about the infection are described in this review.

scholarly journals 1147. Short Course of Voriconazole Therapy as a Risk Factor for Relapse of Invasive Pulmonary Aspergillosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S600-S601
Author(s):  
Dong Hoon Shin ◽  
Seung-Jin Yoo ◽  
Jongtak Jung ◽  
Kang Il Jun ◽  
Hyungjin Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Tertiary Care ◽  
Invasive Pulmonary Aspergillosis ◽  
Care Hospital ◽  
Pulmonary Aspergillosis ◽  
Treatment Termination ◽  
Duration Of Therapy ◽  
Short Course ◽  
Life Threatening

Abstract Background Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection which usually occurs in immunocompromised patients. Recommended duration of voriconazole therapy is a minimum of 6-12 weeks for IPA, despite the lack of any firm evidence. In addition, risk factors for relapse of IPA are still unclear. Here, we explored risk factors for IPA relapse after initial treatment. Methods All patients with proven or probable IPA who had finished voriconazole treatment between 2005 and 2019 in a tertiary-care hospital were reviewed. IPA relapse was defined as re-diagnosis of proven or probable IPA at the same site within 1 year after treatment termination. Short course of voriconazole treatment was defined as a treatment less than 9 weeks, which is a median of the recommended minimum duration of therapy from the Infectious Disease Society of America. The radiological response was defined as a reduction in IPA burden by more than 50% on chest computed tomography (CT). Results Of 87 patients who had completed voriconazole treatment, 14 (16.1%) experienced IPA relapse. Multivariable Cox regression identified that short voriconazole treatment duration (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 1.1–12.3; P=0.033) and radiological non-response (aHR, 4.6; 95% CI, 1.2–17.5; P=0.026) were independently associated with relapse of IPA after adjusting for several clinical risk factors. Conclusion Less improvement in CT, and short duration of voriconazole therapy were the independent risk factors for relapse after treatment of IPA. Longer duration of therapy should be considered for those at higher risk of relapse. Disclosures All Authors: No reported disclosures

scholarly journals Short course of voriconazole therapy as a risk factor for relapse of invasive pulmonary aspergillosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Dong Hoon Shin ◽  
Seung-Jin Yoo ◽  
Kang Il Jun ◽  
Hyungjin Kim ◽  
Chang Kyung Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Tertiary Care ◽  
Invasive Pulmonary Aspergillosis ◽  
Care Hospital ◽  
Pulmonary Aspergillosis ◽  
Treatment Termination ◽  
Duration Of Therapy ◽  
Short Course ◽  
Radiological Response

Abstract To investigate associations of the duration of voriconazole treatment and radiological response with relapse of invasive pulmonary aspergillosis (IPA) in immunocompromised patients, we explored the risk factors for IPA relapse after successful initial treatment. All patients with proven or probable IPA who had finished voriconazole treatment between 2005 and 2019 in a tertiary-care hospital were reviewed. IPA relapse was defined as re-diagnosis of proven or probable IPA at the same site within 1 year after treatment termination. Short course of voriconazole treatment was defined as a treatment less than 9 weeks, which is a median of the recommended minimum duration of therapy from the Infectious Disease Society of America. The radiological response was defined as a reduction in IPA burden by more than 50% on chest computed tomography. Of 87 patients who had completed voriconazole treatment, 14 (16.1%) experienced IPA relapse. Multivariable Cox regression identified that short voriconazole treatment duration (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 1.1–12.3; P = 0.033) and radiological non-response (aHR, 4.6; 95% CI, 1.2–17.5; P = 0.026) were independently associated with relapse of IPA after adjusting for several clinical risk factors. Longer duration of therapy should be considered for those at higher risk of relapse.

Invasive Pulmonary Aspergillosis: Identification of Risk Factors

2002 ◽  
Vol 34 (11) ◽  
pp. 819-822 ◽  
Author(s):  
Mohamed Farouk Allam ◽  
Amparo Serrano del Castillo ◽  
Carmen Díaz-Molina ◽  
Rafael Fernández-Crehuet Navajas
Keyword(s):  
Risk Factors ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis

scholarly journals Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works

1987 ◽  
Vol 99 (2) ◽  
pp. 407-412 ◽  
Author(s):  
M. Perraud ◽  
M. A. Piens ◽  
N. Nicoloyannis ◽  
P. Girard ◽  
M. Sepetjan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidemiological Study ◽  
Fungal Spores ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Protective Measures ◽  
Insulation Materials ◽  
Acoustic Insulation ◽  
Hospital Building ◽  
Set Up

SUMMARYA retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment.

scholarly journals Galactomannan and 1, 3-β-D-Glucan Assay in Bronchoalveolar Lavage Fluid for the Diagnosis of Invasive Pulmonary Aspergillosis in Malignant and Non-malignant Patients

2021 ◽  
Vol 9 (A) ◽  
pp. 362-366
Author(s):  
Hadir Ahmed El-Mahallawy ◽  
Rana El-Gendi ◽  
Doaa Mohammad Ghaith ◽  
Iman Kamal Behiry ◽  
Soheir Fathy Helal
Keyword(s):  
Bronchoalveolar Lavage ◽  
Fungal Infection ◽  
Bronchoalveolar Lavage Fluid ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Lavage Fluid ◽  
Pulmonary Aspergillosis ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Rule Out

BACKGROUND: Serum 1, 3-β-D-glucan (BDG) assay was recommended for diagnosing fungal infections. AIM: We aimed to assess 1, 3-β-D-glucan in bronchoalveolar lavage (BAL) fluid in invasive pulmonary aspergillosis (IPA). METHODS: Out of 104 patients clinically suspected fungal, 45 were probable, 18 possible, and 41 unlikely according to EORTC/MSG 2008 criteria. Measuring BAL BDG and galactomannan were done. RESULTS: The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) for BDG were 44%, 71%, 62%, and 54%; for galactomannan 84%, 83%, 84%, and 83%; and 93%, 66%, 75%, and 90%, respectively, when combining both tests. A significant different performance of GM; p = 0.0008 was detected in patients with malignant disorders when compared to non-malignant; but not for BDG; p = 0.121. CONCLUSION: We can conclude that BAL-BDG is helpful if positive in a clinically suspected IFI case, but if negative cannot rule out fungal infection. Thus, combining results of BAL-GM and BAL-BDG are recommended.

scholarly journals Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
Yanli Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Risk Factors ◽  
Influenza A ◽  
Invasive Pulmonary Aspergillosis ◽  
Neuraminidase Inhibitor ◽  
Teaching Hospitals ◽  
Multivariate Logistic Regression Model ◽  
Pulmonary Aspergillosis ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Immunocompetent Patients

Abstract Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown. Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191–15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048–1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681–76.764, p <  0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028–6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676–73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002–0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

scholarly journals Invasive Pulmonary Aspergillosis in Patients with SARS-CoV-2 Infection: A Systematic Review of the Literature

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 807 ◽  
Author(s):  
Anna Apostolopoulou ◽  
Zerelda Esquer Garrigos ◽  
Prakhar Vijayvargiya ◽  
Alexis Hope Lerner ◽  
Dimitrios Farmakiotis
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Significant Proportion ◽  
Invasive Pulmonary Aspergillosis ◽  
Organ Transplant ◽  
Clinical Manifestations ◽  
Case Series ◽  
Case Fatality ◽  
Invasive Disease ◽  
Pulmonary Aspergillosis

In this systematic review, we investigate the epidemiology, pathogenesis, risk factors, clinical manifestations, diagnosis and treatment of COVID-19-associated pulmonary aspergillosis (CAPA). We identified 85 cases from 22 studies. The frequency of CAPA is currently unknown but ranges between <5% to >30% in different case series; the possibility of colonization rather than invasive disease is the most important confounder. The vast majority of patients with CAPA did not have any of the classic host risk factors, such as immunosuppression from organ transplant or neutropenia, although a significant proportion (46%) had received corticosteroids. Age, pulmonary comorbidities and male sex were associated with higher mortality. Patients treated with voriconazole had numerically lower case-fatality rate. Clinical vigilance for CAPA is advisable in critically ill patients with COVID-19 who are not improving, even those who do not meet classic host criteria for invasive mycoses, especially if they are receiving corticosteroids. A thorough, multi-faceted diagnostic work-up and early initiation of a mold-active triazole may be lifesaving. Further research studies using standardized, uniform definitions of invasive disease and colonization are urgently needed.

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