Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature

IDCases

Muna A. Almaslamani¹  Samar M. Hashim¹  Ali S. Omrani¹  Shiema Abdalla²  Abdulsalam S. Ibrahim³ 

[1] Communicable Diseases Center and Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar;Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar;Division of Critical Care, Hamad Medical Corporation;

关键词: COVID-19;    aspergillosis;    ICU;    viral pneumonia;   

DOI  :  

来源: DOAJ

【 摘 要 】

Coronavirus Disease 2019 (COVID-19)-associated pulmonary aspergillosis is an emerging entity. We report two fatal cases of putative COVID-19-associated pulmonary aspergillosis. Both cases were diagnosed on the basis of respiratory tract cultures yielding Aspergillus species and otherwise unexplained clinical and radiological deterioration. Existing published literature on COVID-19-associated pulmonary aspergillosis indicate poor outcomes and high mortality. CAPA should be considered in patients with critical COVID-19 who have unexplained progressive respiratory failure despite optimized supportive care. Diagnostic work-up should be initiated as early as possible and should ideally include fungal cultures, galactomannan detection and Aspergillus PCR on tracheal aspirates or broncho-alveolar lavage fluid. Empiric systemic antifungal therapy may be justified in selected cases, pending diagnostic work up results. Large, multi-center studies are required to further understand the pathogenesis of invasive aspergillosis in COVID-19, and the optimal diagnostic and treatment strategies.

【 授权许可】

Unknown