SARS-CoV-2 and Aspergillus section Fumigati coinfection in an immunocompetent patient treated with corticosteroids.
Rev Iberoam Micol
; 38(1): 16-18, 2021.
Article
in English
| MEDLINE | ID: covidwho-947431
ABSTRACT
BACKGROUND:
Patients with severe viral pneumonia are likely to receive high-dose immunomodulatory drugs to prevent clinical worsening. Aspergillus species have been described as frequent secondary pneumonia agents in severely ill influenza patients receiving steroids. COVID-19 patients admitted to Intensive Care Unit (ICU) are receiving steroids as part of their treatment and they share clinical characteristics with other patients with severe viral pneumonias. COVID-19 patients receiving steroids should be considered a putative risk group of invasive aspergillosis. CASE REPORT We are reporting a SARS-CoV-2/Aspergillus section Fumigati coinfection in an elderly intubated patient with a history of pulmonary embolism treated with corticosteroids. The diagnosis was made following the ad hoc definitions described for patients admitted to ICU with severe influenza, including clinical criteria (fever for 3 days refractory to the appropriate antibiotic therapy, dyspnea, pleural friction rub, worsening of respiratory status despite antibiotic therapy and need of ventilator support), a radiological criterion (pulmonary infiltrate) and a mycological criterion (several positive galactomannan tests on serum with ratio ≥0.5). In addition, Aspergillus section Fumigati DNA was found in serum and blood samples. These tests were positive 4 weeks after the patient was admitted to the ICU. The patient received voriconazole and after two month in ICU his respiratory status improved; he was discharged after 6 weeks of antifungal treatment.CONCLUSIONS:
Severely ill COVID-19 patients would be considered a new aspergillosis risk group. Galactomannan and Aspergillus DNA detection would be useful methods for Aspergillus infection diagnosis as they allow avoiding the biosafety issues related to these patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Aspergillus fumigatus
/
Methylprednisolone
/
Invasive Pulmonary Aspergillosis
/
Coinfection
/
SARS-CoV-2
/
COVID-19
/
COVID-19 Drug Treatment
/
Immunocompetence
/
Immunosuppressive Agents
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Language:
English
Journal:
Rev Iberoam Micol
Journal subject:
Microbiology
Year:
2021
Document Type:
Article
Affiliation country:
J.riam.2020.11.001
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