Kyuno D, Kubo T, Tsujiwaki M, Sugita S, Hosaka M, Ito H, Harada K, Takasawa A, Kubota Y, Takasawa K, Ono Y, Magara K, Narimatsu E, Hasegawa T, Osanai M. COVID-19-associated disseminated mucormycosis: An autopsy case report. World J Clin Cases 2022; 10(28): 10358-10365 [PMID: 36246823 DOI: 10.12998/wjcc.v10.i28.10358]
Corresponding Author of This Article
Daisuke Kyuno, MD, PhD, Assistant Professor, Doctor, Department of Pathology, Sapporo Medical University, South-1, West-17, Chuo-ku, Sapporo 0608556, Hokkaido, Japan. kyuno@sapmed.ac.jp
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Daisuke Kyuno, Terufumi Kubo, Akira Takasawa, Yusaku Kubota, Kumi Takasawa, Yusuke Ono, Kazufumi Magara, Makoto Osanai, Department of Pathology, Sapporo Medical University, Sapporo 0608556, Hokkaido, Japan
Mitsuhiro Tsujiwaki, Shintaro Sugita, Michiko Hosaka, Tadashi Hasegawa, Department of Surgical Pathology, Sapporo Medical University, Sapporo 0608556, Japan
Hazuki Ito, Keisuke Harada, Eichi Narimatsu, Department of Emergency Medicine, Sapporo Medical University, Sapporo 0608556, Japan
Author contributions: Kyuno D, Kubo T, and Hosaka M performed the autopsy; Kyuno D, Kubo T, Tsujiwaki M, Sugita S, Ono Y, and Magara K performed the histopathological examination; Takasawa A, Kubota Y, and Takasawa K performed the DNA analysis; Ito H, Harada K, and Narimatsu E provided treatment for this case and performed visualization of the work; Hasegawa T and Osanai M supervised this project and helped with writing the manuscript; Kyuno D drafted the manuscript; all authors reviewed and revised the manuscript.
Informed consent statement: Appropriate written informed consent was obtained from the patient’s family to publish this case report and the project.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daisuke Kyuno, MD, PhD, Assistant Professor, Doctor, Department of Pathology, Sapporo Medical University, South-1, West-17, Chuo-ku, Sapporo 0608556, Hokkaido, Japan. kyuno@sapmed.ac.jp
Received: June 20, 2022 Peer-review started: June 20, 2022 First decision: August 4, 2022 Revised: August 12, 2022 Accepted: August 21, 2022 Article in press: August 21, 2022 Published online: October 6, 2022 Processing time: 98 Days and 23.4 Hours
Abstract
BACKGROUND
Reports of mucormycosis, an infectious disease that commonly affects immunocompromised individuals, have increased during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Disseminated mucormycosis associated with COVID-19 is rare but fatal and is characterized by an aggressive clinical course and delayed diagnosis. Our report documents a case of disseminated mucormycosis after COVID-19 infection. This is a rare pathological autopsy report on COVID-19-associated mucormycosis.
CASE SUMMARY
A 58-year-old man was transferred to our hospital with severe COVID-19 pneumonia. During treatment for acute respiratory distress syndrome, he developed intra-abdominal bleeding that required a right hemicolectomy and ileostomy for hemostasis. The ileostoma and surgical wound developed necrosis followed by sepsis and multi-organ failure, which led to death. An autopsy revealed multiple thrombi associated with Rhizopus oryzae infection, which led to the necrosis of multiple infected organs.
CONCLUSION
Early suspicion and diagnosis followed by treatment are keys to better outcomes of mucormycosis in patients with severe COVID-19.
Core Tip: We document a case of disseminated mucormycosis post-coronavirus disease 2019 (COVID-19) infection. A 58-year-old man underwent a right hemicolectomy during COVID-19 pneumonia. The surgical wound developed necrosis, which was followed by multi-organ failure, leading to death. An autopsy revealed multiple thrombi with Rhizopus oryzae infection, which led to the necrosis of multiple infected organs. Our paper is a rare pathological autopsy report on COVID-19-associated mucormycosis. It is important that treating physicians be aware of the increased risk of mucormycosis in patients with severe COVID-19. Early suspicion and diagnosis followed by treatment are keys to better outcomes.
