A RARE CASE OF ACUTE PULMONARY HISTOPLASMOSIS FOLLOWING COVID-19 INFECTION
Chest
; 162(4):A1776, 2022.
Article
in English
| EMBASE | ID: covidwho-2060859
ABSTRACT
SESSION TITLE COVID-19 Case Report Posters 3 SESSION TYPE Case Report Posters PRESENTED ON 10/19/2022 1245 pm - 0145 pm INTRODUCTION:
The most reported fungal infections in patients with COVID-19 include aspergillosis, invasive candidiasis, and mucormycosis. We hereby present a case of a male who developed acute pulmonary histoplasmosis (APH) after COVID-19 infection. CASE PRESENTATION 51-year-old male with PMHx of COVID-19 infection 3 weeks ago presenting with worsening shortness of breath. Patient had a complicated hospital course with COVID-19 treated with high doses of methylprednisolone. Patient was local to Arizona and lived on a ranch with livestock. CT chest suggestive of multilobar pneumonia and bilateral pleural effusions (Image 1). Coccidiomycosis serology came back negative. Urinary Histoplasma galactomannan antigen came back positive. The diagnosis of APH after COVID-19 infection was established. Patient was started on voriconazole. His symptoms significantly improved. Patient was discharged to skilled nursing facility with outpatient infectious disease follow-up.DISCUSSION:
The current literature on APH in the setting of COVID-19 infection is limited. The few proposed mechanisms are 1. Liberal use of high dose steroids in COVID-19 leading to reactivation of latent H. Capsulatum. 2. Systemic inflammation in COVID-19 causes interstitial lung damage permitting conidia to proliferate leading to acute infection. The Histoplasma urine antigen test is highly sensitive in the diagnosis of APH, especially in immunocompromised patients like our patient. With this case we would like to increase awareness of the possibility of rare fungal infections like APH in patients with COVID-19, as timely diagnosis and appropriate management can lead to improved outcomes.CONCLUSIONS:
Rare fungal infections following COVID-19 have been documented and timely diagnosis and management are imperative to improve patient outcomes. Reference #1 Macedo, Priscila M, et al. APH following COVID-19. Case Report J.Fungi 2021 DISCLOSURES No relevant relationships by Ali Raja no disclosure on file for Yamin Saddouk;No relevant relationships by Parita Soni No relevant relationships by Lyndie Wilkins Parker
antigen; methylprednisolone; voriconazole; adult; Arizona; aspergillosis; awareness; case report; clinical article; coccidioidomycosis; communicable disease; conference abstract; conidium; coronavirus disease 2019; diagnosis; drug megadose; drug therapy; dyspnea; follow up; Histoplasma; hospital discharge; human; human tissue; immunocompromised patient; inflammation; invasive candidiasis; livestock; lung injury; male; middle aged; mucormycosis; multilobar pneumonia; mycosis; nonhuman; nursing home; outcome assessment; outpatient; pleura effusion; pulmonary histoplasmosis; serology; thorax
Full text:
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Chest
Year:
2022
Document Type:
Article
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