Primary Cutaneous Mucormycosis in a Patient with Severe COVID-19 Infection

Abstract

A 47-year-old male was brought to the hospital with the chief complaints of fever, breathlessness and cough since one week. He was a known case of Type 2 Diabetes Mellitus (T2DM) for five years and was on oral hypoglycaemic drugs. On presentation, he was hypoxemic with a SpO2 of 91% at 13 LO2 and his sugar level was 286 mg/dL. Further, chest imaging and Reverse TranscriptasePolymerase Chain Reaction (RT-PCR) was suggestive of severe COVID-19 pneumonia and his hypoxemic respiratory failure required Intensive Care Unit (ICU) stay. He was started on high flow oxygen therapy and due to further worsening of his condition, he required endotracheal intubation and mechanical ventilation. On 18th day after admission, he developed blackish blister lesion, insidious on onset and gradually spreading over right forearm over a week. Skin lesions have grown Mucor spp. in microbiological culture. It was diagnosed as primary cutaneous mucormycosis with no involvement of rhinocerebal region and pulmonary region. Immediately antifungal therapy was started and the lesion started resolving. The patient developed secondary bacterial infection, multiorgan dysfunction, the patient could not be revived. This case report demonstrates cutaneous mucormycosis as a rare possible complication of Coronavirus Disease 2019 (COVID-19) infection and emphasises the risk factors and diagnostic measures which helped to arrive at the diagnosis.

Keywords

• diabetes mellitus
• sepsis
• severe pneumonia