Mucormicosis asociada a la COVID-19 en Venezuela: consideraciones en torno a un caso y revisión de la literatura.
COVID-19 associated mucormycosis in Venezuela: case report and literature review.
Palabras clave:
anfotericina B;CAM, COVID-19, diabetes, mucormicosis, reporte de caso
Resumen
La mucormicosis es una micosis emergente, oportunista, invasiva y severa, de distribución mundial, baja frecuencia y elevada morbi-mortalidad, asociada a estados de inmunodeficiencia. Su incremento como mucormicosis asociada a la COVID-19 (CAM o COVID-19 associated mucormycosis) se registra en la India y en varios países de las Américas. Se describe la presentación y manejo de un caso CAM y se valora la importancia clínica y de salud pública de sus características respecto a casos CAM y no-CAM reportados en la literatura médica. Se exponen, sobre una línea de tiempo, aspectos de diagnóstico epidemiológico, clínico, microbiológico, histopatológico, imagenológico y de su manejo multidisciplinario. Se trató de un paciente masculino de 64 años, procedente del centro-norte de Venezuela, con diabetes mellitus y antecedente de COVID-19 moderada, tratada en forma ambulatoria, quien presentó cuadro de mucormicosis rinosinusal-orbitaria unilateral izquierda, con extensión dentomaxilar. Había iniciado con sinusitis, lesiones palatinas, dolor en región maxilar y movilidad dentaria, 19 días después del diagnóstico de la COVID-19. El diagnóstico micológico basado en histopatología, examen directo y cultivo, señaló Rhizopus spp. El caso se trató exitosamente con anfotericina B, cirugía con abordaje endoscópico y control metabólico. Se discuten la posible influencia de la COVID-19 y su manejo en el desarrollo de la CAM y la importancia del acceso a la salud en esta situación. La mucormicosis debe considerarse entre las complicaciones potenciales en pacientes diabéticos con la COVID-19. La atención integral y el seguimiento de la salud del paciente con la COVID-19 deben mantenerse en todas sus fases.
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Riad A, Shabaan AA, Issa J, Ibrahim S, Amer H, Mansy Y, Kassem I, Kassem AB, Howaldt HP, Klugar M, Attia S. COVID- 19-Associated Mucormycosis (CAM): Caseseries and global analysis of mortality risk factors. J Fungi 2021; 7(10): 837. DOI: 10.3390/jof7100837. https://pubmed.nc bi.nlm.nih.gov/34682258/
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Publicado
2023-06-01
Cómo citar
Royero-León, C., Sojo-Milano, M., Pérez-Castro , L., Barazarte-Sánchez, D., Golaszewski, J. B., Muñoz-Gelvez , R., & Gómez-Daza, F. (2023). Mucormicosis asociada a la COVID-19 en Venezuela: consideraciones en torno a un caso y revisión de la literatura.: COVID-19 associated mucormycosis in Venezuela: case report and literature review. Investigación Clínica, 64(2), 206-225. https://doi.org/10.54817/IC.v64n2a07
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