{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:07:15Z","timestamp":1762999635204},"reference-count":16,"publisher":"Grigore T. Popa University of Medicine and Pharmacy","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Clin Cases"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>Hospitalized patients with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) are at risk for\ndeveloping secondary fungal infections due to greater incidence of preexisting comorbidities and exposure to\niatrogenic factors such as corticosteroid use. We present the case of a 44-year-old Hispanic female discovered unresponsive in her home that was found to have severe hyperglycemia with comorbid COVID-19 (coronavirus disease 2019) associated pneumonia. The patient was intubated and treated with several broad-spectrum\nantibiotics, remdesivir, and corticosteroids but had little improvement in her clinical status. Bronchoscopy was performed and revealed multiple necrotic lesions in the lungs. Endobronchial biopsy and bronchoalveolar lavage samples revealed pauciseptated hyphae consistent with zygomycetes. The patient was treated with multiple antifungals including voriconazole, micafungin, and amphotericin B. However, despite maximal medical therapy, the patient perished. This case highlights that clinicians must carry a high degree of suspicion and a low threshold\nto begin treatment for Mucor in diabetics and other immunosuppressed patients.<\/jats:p>","DOI":"10.22551\/2020.28.0703.10172","type":"journal-article","created":{"date-parts":[[2021,1,11]],"date-time":"2021-01-11T17:58:19Z","timestamp":1610387899000},"page":"46-51","source":"Crossref","is-referenced-by-count":26,"title":["A case report of COVID-19 associated pulmonary mucormycosis"],"prefix":"10.22551","volume":"07","author":[{"given":"Nariman","family":"Khan","sequence":"first","affiliation":[{"name":"UT Health San Antonio, Joe R. and Terry Lozano Long School of Medicine, Department of Internal Medicine, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina G.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"University Health System, Pharmacotherapy and Pharmacy Services, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Villafuerte","family":"Martinez","sequence":"additional","affiliation":[{"name":"UT Health San Antonio, Joe R. and Terry Lozano Long School of Medicine, Department of Medicine, Division of Pulmonary Diseases and Critical Care Medicine, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin C","family":"Proud","sequence":"additional","affiliation":[{"name":"UT Health San Antonio, Joe R. and Terry Lozano Long School of Medicine, Department of Internal Medicine, San Antonio, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"9837","published-online":{"date-parts":[[2020,12]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1. Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med 2020; 10.1016\/j.ajem.2020.09.032","DOI":"10.1016\/j.ajem.2020.09.032"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Mohamed A, Rogers TR, Talento AF. COVID-19 associated invasive pulmonary aspergillosis: Diagnostic and therapeutic challenges. J Fungi (Basel) 2020; 6(3):115. doi: 10.3390\/jof6030115. PMID: 32707965; PMCID: PMC7559350.","DOI":"10.3390\/jof6030115"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. Koehler P, Cornely OA, B\u00f6ttiger BW, et al. COVID-19 associated pulmonary aspergillosis. Mycoses 2020; 63(6):528-534. doi:10.1111\/myc.13096","DOI":"10.1111\/myc.13096"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. Mehta S, Pandey A: Rhino-orbital mucormycosis associated with COVID-19. 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Jeong W, Keighley C, Wolfe R, et al.: The Epidemiology and Clinical Manifestations of Mucormycosis: A Systematic Review and MetaAnalysis of Case Reports. Clin Microbiol Infect 2019; 25(1):26-34. 10.1016\/j.cmi.2018.07.011","DOI":"10.1016\/j.cmi.2018.07.011"},{"key":"ref7","unstructured":"8. Symptoms of Mucormycosis. (2020): https:\/\/www.cdc.gov\/fungal\/diseases\/mucormycosis\/symptoms.html Accessed: December 30, 2020"},{"key":"ref8","unstructured":"9. Pulmonary Mucormycosis. (2020): https:\/\/radiopaedia.org\/articles\/pulmonarymucormycosis?lang=us Accessed: December 30, 2020"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. Hammer MM, Madan R, Hatabu H: Pulmonary  mucormycosis: radiologic features at presentation and over time. AJR Am J Roentgenology 2018; 210(4):742-747. 10.2214\/AJR.17.18792","DOI":"10.2214\/ajr.17.18792"},{"key":"ref10","unstructured":"11. Mucormycosis (zygomycosis). (2020): https:\/\/www.uptodate.com\/contents\/mucormycosis-zygomycosis\/print Accessed: December 30, 2020"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12. Lanternier F, Poiree S, Elie C, et al.: Prospective pilot study of high-dose (10 mg\/kg\/day) liposomal amphotericin B (L-AMB) for the initial treatment of mucormycosis. J Antimicrob Chemother 2015; 70(11):3116-3123. 10.1093\/jac\/dkv236","DOI":"10.1093\/jac\/dkv236"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13. Ibrahim AS, Gebremariam T, Fu Y, Edwards JE Jr, Spellberg B: Combination echinocandinpolyene treatment of murine mucormycosis. Antimicrob Agents Chemother 2008; 52(4):1556-1558. 10.1128\/AAC.01458-07","DOI":"10.1128\/aac.01458-07"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14. Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. 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