Dual Invasive fungal infection by aspergillus and mucor in COVID-19 patient: A rare case report with literature review

Patients with COVID-19, especially those with severe disease, in intensive care units, are particularly vulnerable to bacterial and fungal infections. The most common fungal infections reported include aspergillosis, candidiasis, and mucormycois. Mucormycosis, a potentially life-threatening fungal infection, has contributed to India's COVID-19-related deaths, especially during the second wave of pandemic. Several cases of COVID-19-associated pulmonary aspergillosis (CAPA) have been reported from many countries in Europe, Asia, Australia, and South America. Recently, several cases of rhino-orbito-cerebral mucormycosis in patients with COVID-19 (ROCM) have been reported from India. However, case of COVID-19-associated pulmonary mucormycosis (CAPM) is rarely described in the literature. It has been hypothesized to affect patients recovering from COVID-19 who are immunocompromised due to COVID-19 disease or due to the usage of steroids and/or concomitant diabetes. The authors hereby report a combination of CAPM and CAPA in the same patient and perform a systemic review of the published cases highlighting the differences between these two-life-threatening pulmonary fungal infections.