毛霉菌病在COVID-19大流行期间变得更加普遍,并与高死亡率相关。然而,同时发生宿主过敏反应,侵袭性肺毛霉菌病,播散性毛霉菌病很少报道。在这里,我们描述了一例播散性毛霉菌病最初被误诊为恶性肿瘤的病例,该恶性肿瘤是由SARS-CoV-2感染后的女性中的小根霉引起的过敏性支气管肺真菌病引起的.先前健康的患者表现为右中叶有相当大的肿块,肺部有多处病变,大脑,脾,脾肾脏,胰腺,SARS-CoV-2感染6个月后的皮下组织,模仿广泛的转移性恶性肿瘤。嗜酸性粒细胞增多,血浆总免疫球蛋白E升高,观察到明显的嗜酸性粒细胞肺组织浸润。从皮下组织中分离出微孢子根霉,在肺组织中检测到菌丝。两性霉素B脂质体序贯伊沙康康唑抗真菌治疗联合全身性糖皮质激素改善症状,显著减少肺部病变的大小,嗜酸性粒细胞计数减少.然而,它未能阻止疾病的整体进展,病人死了.缺乏哮喘样症状和对侵袭性真菌感染体征的延迟识别导致预后较差。强调需要在COVID-19后进行彻底的随访。
Mucormycosis has become more prevalent during the COVID-19 pandemic and is associated with a high mortality rate. However, concurrent host allergic reactions, invasive pulmonary mucormycosis, and disseminated mucormycosis are rarely reported. Herein, we describe a case of disseminated mucormycosis initially misdiagnosed as a malignancy that developed from allergic bronchopulmonary mycosis caused by Rhizopus microsporus in a woman with post-SARS-CoV-2 infection. The previously healthy patient presented with a sizeable mass in the right middle lobe and multiple lesions across the lungs, brain, spleen, kidneys, pancreas, and subcutaneous tissue 6 months after SARS-CoV-2 infection, mimicking an extensive metastatic malignancy. Eosinophilia, elevated total plasma immunoglobulin E, and significant eosinophilic lung tissue infiltration were observed. Rhizopus microsporus was isolated from subcutaneous tissue, and hyphae were detected in the lung tissue. Sequential amphotericin B liposomes followed by isavuconazole antifungal therapy combined with systemic corticosteroids improved symptoms, significantly reduced the sizes of pulmonary lesions, and reduced eosinophil count. However, it failed to halt the overall progression of the disease, and the patient died. The absence of asthma-like symptoms and delayed recognition of invasive fungal infection signs contributed to poorer outcomes, highlighting the need for a thorough post-COVID-19 follow-up.