key: cord-1056175-29eptqqj
authors: Das, Srijit; Dhar, Subhra
title: Mucormycosis Following COVID-19 Infections: an Insight
date: 2021-07-10
journal: Indian J Surg
DOI: 10.1007/s12262-021-03028-1
sha: 1672d7defbf506e7171224211af417e1ad0d157b
doc_id: 1056175
cord_uid: 29eptqqj

nan

Mucor is a saprophytic fungus present in the soil, air, food, and even in the nasal mucosa of the healthy individual as a commensal [5] . The diagnosis of mucormycosis may be missed or misdiagnosed and it may be life threatening. Mucormycosis is a severe infection and it may destroy the local vasculature which makes the treatment with antifungal agents becomes more challenging. Mucormycosis is treated with different drugs such as amphotericin B, isavuconazole, and posaconazole. At times, surgical debridement or even amputations are needed.

It was known earlier that zinc inhibits growth of mucormycosis but, interestingly, recent studies reveal that antimicrobials act by reducing the intracellular level of zinc and such has been seen in the case of the drug Atovaquone which is used for treatment of Candida albicans, Aspergillus sp., and Fusarium sp. [6] . Fungi are known to be susceptible to zinc deficiency in vitro. Their growth is reduced by use of zinc chelators like clioquinol, phenanthroline, etc. [7] . Proper understanding of the zinc transporters, zinc-responsive transcription factors of fungi, and zinc-binding proteins in the cytosol and organellar compartment may be important. Excess zinc level could also displace other redox-active metals in the body. It cannot be refuted that other proteins in the cytosol also compete for zinc binding. The mucormycosis epidemic exposed the healthcare system including lack of practice of evidence-based medicine, and poor medical practice across which led to indiscriminate steroid/antibiotic use in COVID-19 and beyond. In future studies, researchers may look at other possible risk factors including monitoring appropriate dose of steroids and studying the incidence of infections in rural and urban patients.

Centre for Disease Control and Prevention

Melanised fungi in human disease

Epidemiology and clinical manifestations of mucormycosis

Nosocomial fungal infections: epidemiology, diagnosis and treatment

Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature

Atovaquone impairs growth of Aspergillus and Fusarium keratitis isolates by modulating mitochondrial function and zinc homeostasis

Administration of zinc chelators improves survival of mice infected with Aspergillus fumigatus both in monotherapy and in combination with caspofungin