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Invasive Fusarium rhinosinusitis in COVID-19 patients: report of three cases with successful management

Summary

This study reports three cases of rare fungal sinus infections caused by Fusarium species that developed in COVID-19 patients. All three patients were successfully treated with a combination of surgical removal of infected tissue and antifungal medications. The cases highlight how COVID-19 and the use of steroids to treat it can increase the risk of serious fungal infections, emphasizing the importance of early detection and prompt treatment.

Background

Invasive fungal rhinosinusitis (IFRS) is a life-threatening infection occurring in immunocompromised patients, including those with COVID-19. While Mucorales and Aspergillus species are the most common causes, infections caused by Fusarium species are rare but increasingly reported.

Objective

To present and describe three cases of proven Fusarium rhinosinusitis that occurred during or after COVID-19 infection, with confirmed diagnosis through microscopy, pathology, and molecular identification.

Results

Three cases were identified as Fusarium proliferatum, F. oxysporum with Aspergillus flavus co-infection, and F. solani/falciforme, respectively. All cases were successfully treated with endoscopic surgical debridement combined with antifungal therapy (liposomal amphotericin B, voriconazole, or posaconazole), though one patient experienced recurrence 15 months later.

Conclusion

Early diagnosis and timely medical and surgical intervention are crucial in reducing mortality from invasive fusariosis in COVID-19 patients. Cautious use of corticosteroids in COVID-19 patients is highly recommended to minimize secondary fungal infection risk.
  • Published in:Frontiers in Cellular and Infection Microbiology,
  • Study Type:Case Report,
  • Source: PMID: 37780844; DOI: 10.3389/fcimb.2023.1247491
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