Post-COVID pulmonary aspergillosis - A case report

ABSTRACT

Introduction: Novel coronavirus disease started in December 2019 and declared pandemic on march 11 2020. Viral pneumonia increases patients susceptibility to bacterial and fungal infections and those who were admitted to ICU had a higher probability of infection. Case Report A 33yr old female came to the hospital with chief complaints of cough with expectoration associated with streaky haemoptysis and generalised weakness since 20 days. There was a h/o hospital admission for covid and patient was on NIV support. Patient was denovo diabetic. On examination pallor present and decreased breath sounds in bilateral infrascapular and infraaxillary areas. Investigations Chest X ray showed bilateral mid and lowerzone non-homogenous opacities. Sputum for AFB, CBNAAT and KOH were negative. Sputum culture & sensitivity showed streptococcus. HRCT chest was done which showed multiple cavitary lesions in bilateral lung fields. Bronchoscopy was done and washings showed branching septate hyphae on KOH mount suggestive of aspergillosis. Patient was started on antifungals and symptomatic improvement was seen. Conclusion: Pulmonary aspergillosis is a serious complication in postcovid patients and high index of clinical suspicion and focused diagnostic approach is essential for early diagnosis and treatment which may improve the outcome.