ABSTRACT
Background:One of the complication of Coronavirus disease (COVID-19) is secondary infection. The patients with severe Covid-19 who are admitted in ICU are at increased risk of developing co-infections due to various reasons. Recent stud- ies have showed that 19-26% of patients admitted in ICU developed Pulmonary Aspergillosis. But most of the cases are underdiagnosed due to difficulties in diagnostic methods to collect clinical samples due to the aerosols generation. In this case report, Aspergillus was isolated from sputum sample of a patient. Methods:A 53 years old male patient recovered from Covid-19 two months back presented with c/o chest pain, difficul- ty in breathing and Haemoptysis to the emergency department. On admission, O2 saturation was 70%, Xray Chest re- vealed B/L midzone cavity, CT chest: Paraseptal emphysematous changes, involving B/L upper lobe (Grade 4). Hb: 7g/dl, WBC count 17000cell/cumm (Neutrophil -79%), CRP: 153mg/L, IL-6- 804 pg/mL. The patient was suspected to have bac- terial and fungal co-infection. He was empericallly started with Meropenam, Voriconazole and ATT. GenExpert for MTB was negative. The sputum, blood, urine and stool samples were received in Microbiology laboratory for bacterial and fungal culture. Blood, Sputum, Urine & Stool culture were negative for bacterial pathogens. Fungal culture: Heavy growth of Aspergillus fumigatus was observed within 72 hours in sputum sample. Results:COVID-19 associated with Pulmonary Aspergillosis is a recently described syndrome that affect Covid -19 pa- tients with ARDS. In this case we reported Aspergillus fumigatus in culture as secondary infection 2 months after Covid pneumonia. Conclusions:Invasive Pulmonary Aspergillosis may complicate severe Covid-19 pneumonia. Hence in ICU patients with Pneumonia who do not respond to antibiotics, sputum sample has to be subjected for fungal culture. Antifungal suscep- tibility testing should also be performed due to the global emergence of triazole resistance.