Covid-19 Associated Fungal Pneumonia: A Case Series

ABSTRACT

Fungal pneumonias are difficult to diagnose and are likely underestimated. Aspergillus and Candida infections in COVID-19 patients will require early detection by a comprehensive diagnostic intervention {histopathology, direct microscopic examination, culture, (1,3)-β D-glucan, galactomannan, and PCR-based assays} to ensure effective treatments. Particularly in the setting of COVID-19, where the clinical picture, and radiological findings of fungal pneumonia resemble those of severe COVID-19;blood tests lack sensitivity and, most importantly, sampling of the primary site of infection is rarely performed, due to the risk of COVID-19 transmission through bronchoscopy with bronchoalveolar lavage. We performed Fiber-optic bronchoscopy and collected samples in all 5 cases of this series, and confirmed the diagnosis of CAPA which made it possible to start treatment timely.