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Successful treatment of proven coronavirus disease 2019-associated pulmonary aspergillosis with liposomal amphotericin B in a patient with bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation.
Nakaya, Yosuke; Nakashima, Yasuhiro; Harada, Naonori; Yamada, Koichi; Makuuchi, Yosuke; Kuno, Masatomo; Takakuwa, Teruhito; Okamura, Hiroshi; Nanno, Satoru; Nishimoto, Mitsutaka; Koh, Hideo; Nakagama, Yu; Kido, Yasutoshi; Kanno, Takayuki; Suzuki, Tadaki; Nakamae, Hirohisa; Kakeya, Hiroshi; Hino, Masayuki.
  • Nakaya Y; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Nakashima Y; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan. Electronic address: ynakashima@omu.ac.jp.
  • Harada N; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Yamada K; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Makuuchi Y; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Kuno M; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Takakuwa T; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Okamura H; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Nanno S; Department of Hematology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan.
  • Nishimoto M; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Koh H; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Nakagama Y; Department of Parasitology and Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Kido Y; Department of Parasitology and Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Kanno T; Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.
  • Suzuki T; Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.
  • Nakamae H; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Kakeya H; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
  • Hino M; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
J Infect Chemother ; 2022 Nov 13.
Article in English | MEDLINE | ID: covidwho-2233655
ABSTRACT
Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is being increasingly recognized as a severe complication that contributes to poor prognoses among patients with COVID-19. However, little is known regarding the clinical course of CAPA with hematological malignancies, especially after allogeneic hematopoietic stem cell transplantation (HSCT). A 29-year-old woman was diagnosed with proven CAPA with an Aspergillus fumigatus identified by cultures of bronchoalveolar lavage and lung biopsy four years after haploidentical HSCT for acute myelogenous leukemia. She had been taking oral prednisolone for bronchiolitis obliterans syndrome that developed after HSCT. Although prolonged RT-PCR positivity for SARS-CoV-2 (133 days after the onset of COVID-19) without shedding of viable virus was observed, the COVID-19 was treated with favipiravir, remdesivir, dexamethasone, and enoxaparin. However, the CAPA did not respond to combination therapy, which included triazole (voriconazole, itraconazole, posaconazole) and echinocandin (caspofungin, micafungin), even though the Aspergillus fumigatus isolate was found to be susceptible to these agents in vitro. Nevertheless, a total of 16 weeks of liposomal amphotericin B (L-AMB) therapy led to a favorable response, and the patient was discharged from the hospital on day 213. This case provided essential experience of CAPA treated with L-AMB in a recipient with chronic respiratory disease after HSCT.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article Affiliation country: J.jiac.2022.10.020

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal subject: Microbiology / Drug Therapy Year: 2022 Document Type: Article Affiliation country: J.jiac.2022.10.020