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COVID-19-associated pulmonary mucormycosis

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of COVID-19-associated pulmonary mucormycosis are prepared by our editorial team based on guidelines from the Academy of Pulmonary Sciences (APS/FISF 2022). ...
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Diagnostic investigations

Diagnostic imaging: as per APS/FISF 2022 guidelines, obtain CT with IV contrast in the initial evaluation of patients with COVID-19-associated pulmonary mucormycosis.
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  • Laboratory tests

Diagnostic procedures

Bronchoscopy: as per APS/FISF 2022 guidelines, perform early flexible bronchoscopy in most patients with COVID-19-associated pulmonary mucormycosis due to the following advantages:
visualization of airway abnormalities
performing endobronchial biopsies
provision of samples representing the lower respiratory tract (BAL or bronchial washings).
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  • Biopsy

Medical management

Antifungal therapy, initial: as per APS/FISF 2022 guidelines, administer liposomal amphotericin B 5 mg/kg/day as first-line therapy in patients with COVID-19-associated pulmonary mucormycosis. Consider escalating the dose to 10 mg/kg/day in patients with intracranial involvement.
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  • Antifungal therapy (maintenance)

  • Antifungal therapy (treatment failure)

Surgical interventions

Lung resection: as per APS/FISF 2022 guidelines, perform lung resection in all patients with potentially resectable lung disease.
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