The first report of rhinosinusitis by Rhizopus delemar in a patient with severe COVID-19 in Iran: a case report

Seyedeh Sabereh Mojtahedi, Neginsadat Hosseinikargar, Hossein Zarrinfar*, Mehdi Bakhshaee, Mohammad Javad Najafzadeh, Ya Bin Zhou, Jos Houbraken

*Corresponding author for this work

Research output: Contribution to journal/periodicalArticleScientificpeer-review

Abstract

Background: Mucormycosis is a severe and fatal fungal infection in patients with coronavirus disease 2019 caused by Mucorales. Here we present a case of a 63-year-old man with coronavirus disease 2019 infection, along with rhinosinusitis mucormycosis caused by Rhizopus delemar. Case presentation: A 63-year-old Iranian man suffering from a coronavirus disease 2019 infection with symptoms of cough, shortness of breath, and generalized body pain. On the basis of the clinical manifestations, such as headache, a history of black nasal discharge, nasal hypoesthesia, facial swelling, numbness, nasal obstruction, presence of necrotic lesions on the nasal passages on physical examination, and abnormal computed tomography scans of paranasal sinuses, the patient underwent surgical debridement. Direct microscopy of specimens obtained from the paranasal sinuses, and subsequent isolation and identification, revealed a rhinosinusitis mucormycosis caused by R. delemar. Despite therapeutic measures, such as sinus debridement surgery and antifungal therapy with amphotericin B injection (50 mg/day), the patient died after 35 days of hospitalization. Conclusion: In this report, we present the first documented case of human infection with R. delemar in a patient with coronavirus disease 2019 infection, who also exhibited rhinosinusitis mucormycosis. R. delemar appears to be an emerging agent of rhinosinusitis mucormycosis in this region. Furthermore, prompt diagnosis and the exploration of alternative antifungal treatments, beyond amphotericin B, may be crucial for effectively managing patients with R. delemar infections.

Original languageEnglish
Article number522
JournalJournal of Medical Case Reports
Volume18
Issue number1
DOIs
Publication statusPublished - Dec 2024

Keywords

  • COVID-19
  • Infection
  • Mucormycosis
  • Rhinosinusitis
  • Rhizopus delemar

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