Mumbai: Mucormycosis, bleeding pituitary gland in Covid patient stump doctors

Doctors said they were also surprised by the rapid deterioration of woman’s condition

The mystery of infections triggered by Covid-19 continues to baffle doctors, with the latest being a 46-year-old woman developing rare complications after she contracted the Coronavirus.

The South Mumbai resident was brought to Mumbai Central's Wockhardt Hospital with severe headache complaints. She was diagnosed with pituitary adenoma macro (benign tumour growth in pituitary gland) with bleeding in the pituitary gland.

"She had no comorbidities like diabetes or hypertension. Before coming to us, she had a history of fever and inflammation of her salivary glands for 8 days. When we saw her, she had a severe headache, no fever on admission. The Rapid Antigen and RTPCR tests for Covid were negative. Even the CT Scan didn't say much," said Dr Kedar Toraskar, critical care specialist, Wockhardt Hospital.

An MRI scan showed a bigger problem. "The bleeding in the pituitary gland, called as pituitary apoplexy, is one of the literature reported complications of Covid-19. It is a rare complication. We repeated the RTPCR for the third time and it came positive," said Dr Toraskar.

He said by the time the third test came positive, her condition had worsened. "She had swelling in the eye region, got a fever. We evaluated her for mucormycosis. The second MRI scan showed presence of mucormycosis," said Dr Toraskar.

He added that she also had fungal meningitis, wherein the infection had spread from her bloodstream to the brain or spinal cord.

"We have not seen so many complications in a person that too when she didn't have any comorbidity. It proves that Covid-19 is an independent risk factor for mucormycosis. Normally, pre-Covid-19 era, we saw mucormycosis in diabetic patients with uncontrolled diabetes and on immunosuppressants or in post-transplant patients. This patient was not even on steroids." While the woman passed away after 15 days, Dr Toraskar said, even the bleeding in the pituitary gland is rare in Covid cases. "She had mucormycosis, pituitary macroadenoma, pituitary bleed together. The rapid deterioration of her condition too stumped us. We wish we could save her. We are going to present this case in the medical journal because of the rare representation," said Dr Toraskar.

Dr Vasant Nagvekar, infectious disease expert at Global Hospital, shared a similar experience. "We saw one case of Covid-19 who had pituitary gland involvement and had mucormycosis. He was 45-year-old and we had to operate on him and for pituitary gland, we replaced the hormone deficiency. However, he was a known diabetic patient who had uncontrolled blood sugar levels," said Dr Nagvekar.

Talking about the virus being the sole reason for mucormycosis, Dr Nagvekar said his team saw 10 per cent of the total mucormycosis patients not having diabetes or being on steroids and still getting the infection after contracting Covid-19.

"Any dental complaints, numbness on the face after being tested positive for Covid-19 has to be taken seriously and shown to the doctor," said Dr Nagvekar.

15
No. of days after which the victim died