Thread: A mab/steroid related fungal horror story from Covid 2020.

46 yr old friends brother survived severe Covid pneumonia & myocarditis after weeks on ventilator. Received Tocluzimab kilo loads of steroids where he was admitted.

Admitted with fever/heart failure with us.
Urine exam showed Candida infection. CT abdomen showed an infarcted right kidney, thrombosis renal artery & vein
Taken into the OT for right nephrectomy, the surgeon saw completely necrosis kidney. A GI surgeon was called in to inspect the retroperitoneum/duodenum/Transverse colon which were intact. Histo & microbiology later showed INVASIVE MUCORMYCOSIS.
Day 3, drain turned brown. Repeat CT showed air in the gut. Endoscopy revealed a rent in 3rd part of duodenum. Ovesco clipping done.
After 48 hours of quiet, drain flowed incessantly. A repeat endoscopy showed bigger rent. Large duodenal stent was inserted to no avail. Desperate surgical option was offered in extremis for the relentlessly invading fungus. We lost him even before a decision could be reached
That’s a post Covid, post monoclonal antibody, mega steroid dose related fungus story. We must be more judicious with therapies with no proven benefits.
@drmandark your post prompted me to put out this stoty 🙏🏽

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