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Chest ; 161(1): e5-e11, 2022 01.
Artículo en Inglés | MEDLINE | ID: covidwho-1595933

RESUMEN

CASE PRESENTATION: A 67-year-old obese man (BMI 38.0) with type 2 diabetes mellitus (DM), chronic atrial fibrillation, and chronic lymphocytic leukemia stage II, stable for 8 years after chemotherapy, and a history of smoking presented to the ED with progressive dyspnea and fever due to SARS-CoV-2 infection. He was admitted to a general ward and treated with dexamethasone (6 mg IV once daily) and oxygen. On day 3 of hospital admission, he became progressively hypoxemic and was admitted to the ICU for invasive mechanical ventilation. Dexamethasone treatment was continued, and a single dose of tocilizumab (800 mg) was administered. On day 9 of ICU admission, voriconazole treatment was initiated after tracheal white plaques at bronchoscopy, suggestive of invasive Aspergillus tracheobronchitis, were noticed. However, his medical situation dramatically deteriorated.


Asunto(s)
Lesión Renal Aguda/virología , Antifúngicos/uso terapéutico , COVID-19/complicaciones , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Aspergilosis Pulmonar/diagnóstico , Aspergilosis Pulmonar/tratamiento farmacológico , Anciano , Anfotericina B/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Fibrilación Atrial/complicaciones , Broncoscopía , Dexametasona/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Resultado Fatal , Humanos , Leucemia Linfocítica Crónica de Células B/complicaciones , Masculino , Nitrilos/uso terapéutico , Obesidad/complicaciones , Terapia por Inhalación de Oxígeno , Piridinas/uso terapéutico , Respiración Artificial , SARS-CoV-2 , Fumar/efectos adversos , Tomografía Computarizada por Rayos X , Triazoles/uso terapéutico , Voriconazol/uso terapéutico
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