Proven pulmonary aspergillosis in a COVID-19 patient: A case report

Document Type : Case report

Authors

1 Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Pathology, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran, Iran

5 Central Laboratory, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran, Iran

6 Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

7 Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran

8 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Department of Medical Microbiology and Parasitology, College of Health Sciences, Faculty of Clinical Sciences,

10.18502/CMM.7.2.7031

Abstract

Background and Purpose: Coronavirus disease 2019 (COVID-19) has become a significant clinical challenge in healthcare settings all over the world. Critically ill COVID-19 patients with acute respiratory distress syndrome may be at increased risk of co-infection with pulmonary aspergillosis. This study aimed to describe a clinical case of proven pulmonary aspergillosis caused by Aspergillus tubingensis in a 59-year-old man with a history of hospitalization due to COVID-19 infection.
Case report: The Covid-19 infection was confirmed by positive nasopharyngeal polymerase chain reaction. He had a cavitary lesion measured 20 mm in diameter with intracavitary soft tissue density in the left lung in the first chest computerized tomography scan. After 25 days, he showed two cavitary lesions in both lungs which raised suspicion of fungal infection; hence, the patient underwent a trans-thoracic biopsy of the cavitary lesion. The direct examination and culture of the biopsy material revealed Aspergillus species. To confirm the Aspergillus species identification, the beta-tubulin region was sequenced. The patient was treated with oral voriconazole.
Conclusion: This report underlined the importance of early diagnosis and management of invasive fungal infections in severe COVID-19 patients
 

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