Yesterday, a report was published on the website of the American Journal of Case Reports,
A rare case of a coronavirus infected person who was infected with mucormyces at the same time and was "gnawed" off half of his face was announced.
The patient is a 37-year-old Iranian man who contracted the new crown and went to the doctor because of severe symptoms.
Previously, the patient did not have any other underlying diseases other than chronic sinusitis,
After being infected with the new crown, 40% of his lungs appeared shadows, and he also showed symptoms of diabetes,
So he was hospitalized with antiviral drugs and treated for diabetes.
After a few days, the patient's new crown symptoms subsided and he was discharged from the hospital,
But the diabetes has not improved, and then it is necessary to inject insulin as directed by the doctor.
But a few days after being discharged, the man went to the hospital again,
This time it was because of headaches and pain in the maxillary area, and swelling and pus from the gums.
The dentist first gave him injections and oral antibiotics and used antiseptic mouthwash, and his symptoms were not relieved.
The patient was then referred to an otolaryngologist for consultation with an ophthalmologist
Through CT scans and MRIs, doctors found moderate and mild shadows of his maxillary sinuses on both sides, as well as infiltrates of surrounding tissues.
But his vision was normal and there were no signs of Mucormycosis infection.
The doctor determined that he had acute sinusitis and prescribed him antibiotics again.
After 3 days, the patient's symptoms remained unresolved, severe pain began in the maxillary area, purulent discharge from the gums.
He was again referred to a periodontist, who found that his blood sugar was consistently high, he had multiple gingival abscesses, distinct shadows in both maxillary sinuses, and perforations in the nasal floor and maxillary sinus walls.
Depending on the patient's symptoms at this time, doctors believe that mucormyces infection and osteomyelitis caused by diabetes are more likely causes.
In order to relieve the patient's pain, the doctor drained pus from his gums, which worked well at first, but then the pain and suppuration became more serious.
The patient made a third referral, this time he came to see the maxillofacial surgery, by which time the patient's condition was already serious.
After consultation with the ophthalmologist and otolaryngology, the doctors concluded that he was most likely infected by Mucormyces.
Mucormyces are found throughout the environment and can cause infection, known as mucormycosis, when inhaled by humans.
Mucormycosis is a serious and rare fungal infection that occurs in the nose-mouth, brain, and lungs.
Cutaneous mucormycosis may also occur in cuts, burns, and other skin injuries, as well as gastrointestinal mucormycosis and disseminated mucormycosis.
Mucormyces invade blood vessels, causing blood clots, causing ischemia, infarction, and necrosis of surrounding tissues, as if the surrounding tissues had been eaten away.
Mucormycosis is not particularly common, with an overall mortality rate of 54%, with mortality varying by site infection,
For example, the mortality rate for nasal mucormycosis is 46%, for pulmonary mucormycosis is 76%, and for disseminated mucormycosis is as high as 96%.
Depending on the severity of the patient's condition, the doctor decided to operate on him.
Soon, the patient underwent maxillofacial surgery under general anesthesia.
After doctors opened his maxillofacial area, they found that his gum infection was severe and had spread to the mouth, nose and jaw, and the lower half of his face was completely unrecognizable.
Doctors removed one of his jaws and extracted 12 teeth from the upper and lower gums,
Black necrotic tissue was also removed from the maxillary sinuses on both sides of his body, and necrosis in the lower turbinate was also removed.
(A: part of the jaw removed, B: extracted tooth)
After the operation, the doctor conducted a pathological examination on the removed tissue, and finally confirmed that the patient was indeed infected by Mucormyces.
The doctor judged that he was infected with the new crown, his immunity was reduced, giving mucormyces an opportunity.
The doctor immediately arranged antifungal therapy for him, and after the patient's lesions were removed, this round of treatment worked well,
His surgical wound healed smoothly and there was no maxillary sinus fistula,
After some time, the patient finally recovered and was discharged from the hospital.
(CT scan after surgery)
The doctor followed him for 6 months and the man never showed signs of infection again,
This is followed by maxillofacial reconstruction to fill in the excised tissue with implants.
According to current statistics, there are not many cases of mucormycosis after the new crown infection, and even fewer cases of oral infection.
A previous report in the Netherlands investigated similar patients with nasal, eye, brain, lung, and disseminated mucormyces infections, respectively.
Two of the patients with diabetes and one non-diabetic died.
In this way, for the patients who have just been announced,
Even though he has suffered a lot of sins, he is quite lucky to save his life...