COVID-19 Associated Pulmonary Aspergillosis: A Case Series.

Coronavirus disease 2019 (COVID-19) has been a worldwide pandemic with several problems, one of which is the lack of definitive treatment. COVID-19-associated pulmonary aspergillosis (CAPA), the presence of invasive pulmonary aspergillosis (IPA) in COVID-19 patients, is one of the concerning secondary infections associated with higher mortality and worse clinical outcomes. Diagnosing CAPA may be challenging due to the possible absence of classic host factors and clinical symptoms or obscured radiological findings. We described two CAPA cases, which were suspected due to persistent respiratory failure despite standard treatment of COVID-19 with additional therapies and antimicrobial agents for secondary infections, eventually diagnosed with serum galactomannan testing. Clinical conditions of both patients improved significantly after the administration of voriconazole. This case series emphasizes the importance of being aware of clinical suspicions indicating CAPA followed by galactomannan testing as a relatively fast, noninvasive test for its diagnosis, which leads to appropriate antifungal treatment.

Misleading Diagnosis of Radiological Imaging of COVID-19 Pneumonia During Pandemic Era: Risk on the Existence of CMV Infection.

Coronavirus disease 2019 (COVID-19) is an acute respiratory disease which rapidly disseminated due to Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) virus. Clinical presentations of COVID-19 are fever, non-productive cough, and dyspnea. Although the diagnosis establishment is done by detecting the viral ribonucleic acid (RNA) through reverse transcription-polymerase chain reaction (RT-PCR) method, CT scan has an important role in detection and treatment of COVID-19 especially in high prevalence regions. Chest CT scan has high sensitivity yet low specificity because there are a lot of other pathological spectrums that also present features of COVID-19 such as ground glass opacities (GGO) and consolidation, one of them is CMV infection. The objective of this case report is to raise vigilance towards other diseases that have radiological image similarities with COVID-19, especially in the immunocompromised patients who are susceptible to viral infections like CMV infection so that the delay in the disease treatment can be prevented.