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Proven Aspergillus flavus pulmonary aspergillosis in a COVID-19 patient: A case report and review of the literature.

ABSTRACT: Severe COVID-19 patients complicated with aspergillosis are increasingly reported. We present a histopathological proven case of fatal COVID-19-associated pulmonary aspergillosis (CAPA), due to Aspergillus flavus. This report and existing published literature indicate diagnostic challenges and poor outcomes of CAPA in ICU patients.

SUBMITTER: Salehi M

PROVIDER: S-EPMC8014135 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Proven Aspergillus flavus pulmonary aspergillosis in a COVID-19 patient: A case report and review of the literature.

Salehi Mohammadreza M Khajavirad Nasim N Seifi Arash A Salahshour Faeze F Jahanbin Behnaz B Kazemizadeh Hossein H Hashemi Sayed Jamal SJ Dehghan Manshadi Seyed Ali SA Kord Mohammad M Verweij Paul E PE Khodavaisy Sadegh S

Mycoses 20210302 8

Severe COVID-19 patients complicated with aspergillosis are increasingly reported. We present a histopathological proven case of fatal COVID-19-associated pulmonary aspergillosis (CAPA), due to Aspergillus flavus. This report and existing published literature indicate diagnostic challenges and poor outcomes of CAPA in ICU patients. ...[more]

PMID: 33576014

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Mycetoma due to <i>Aspergillus flavus</i> in a diabetic patient: Case report and literature review.

Project description:Diabetes mellitus patients are prone to cutaneous and subcutaneous fungal infections due to pathogenic fungi, including dermatophytes, Mucorales, Candida, Aspergillus, and Fusarium species. Here, we report a case of A. flavus mycetoma confirmed by isolation and molecular identification. The case was a 38-year-old male farmer with a seven-year history of type 2 diabetes mellitus, living in Khuzestan, southwest of Iran. The patient presented with a right foot swelling associated with a nodule and multiple discharging sinuses following trauma sustained on the foot while working barefoot on the rice farm, a year ago. The nodule appeared at the site of the trauma two months after the injury. The initial diagnosis was based on direct microscopic examination of lesions scraping using 20% potassium hydroxide and radiology. Molecular analysis confirmed the isolates to be A. flavus. In vitro susceptibility of the isolate to voriconazole, posaconazole, caspofungin, itraconazole, and amphotericin B was determined. Treatment with voriconazole (200 mg twice daily) stopped the purulent discharge, reduced the swelling, and improved the clinical condition within two months. The study emphasizes the importance of wearing footwear to prevent skin trauma as the main risk factor of patient involvement.

| S-EPMC9344346 | biostudies-literature

Pulmonary Mycobacterium parascrofulaceum Infection in a Patient with Chronic Progressive Pulmonary Aspergillosis: A Case Report and Literature Review.

Project description:A 67-year-old man with a pulmonary cavity was admitted to our hospital. Mycobacterial culture of the bronchoalveolar lavage fluid sample obtained from the right upper pulmonary lesion tested positive for mycobacterium, and sequencing of the 16S rRNA genes, hsp65, and rpoB revealed that the cultured mycobacterium was Mycobacterium parascrofulaceum. Treatment with antimycobacterial agents was ineffective, and repeated culturing of bronchoscopic specimens revealed that the specimens were positive for Aspergillus fumigatus. Combination treatment of antimycobacterial agents and voriconazole improved the lung lesion. This is the first report of a patient with pulmonary M. parascrofulaceum infection complicated with chronic progressive pulmonary aspergillosis.

| S-EPMC7332639 | biostudies-literature

COVID-19 associated pulmonary aspergillosis (CAPA): An Australian case report.

Project description:As the COVID-19 pandemic has developed, concern for invasive fungal infections in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) has emerged. We describe a clinical case of coronavirus disease (COVID-19) associated pulmonary aspergillus (CAPA) infection and acute respiratory distress syndrome (ARDS) with a good clinical outcome, in a previously well, non-immunocompromised Australian woman.

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Case Report: Infective Endocarditis Caused by <i>Aspergillus flavus</i> in a Hemodialysis Patient.

Project description:Fungal endocarditis (FE) is a rare but fatal disease. The incidence of infective endocarditis (IE) in hemodialysis patients with catheters is thought to be obviously higher than that in the general population. We reported a case of IE caused by Aspergillus flavus (A. flavus) in a 36-year-old woman on hemodialysis. Because the blood cultures were persistently negative, so we used mNGS (Metagenomic next generation sequencing) for early clinical diagnosis. After treatment with voriconazole, the patient's condition improved rapidly. She continued oral voriconazole treatment 1 year after discharge and is in good condition. The diagnosis and treatment strategies of FE in hemodialysis patients were discussed.

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Aspergillus fumigatus and Aspergillus flavus-Specific IgG Cut-Offs for the Diagnosis of Chronic Pulmonary Aspergillosis in Pakistan.

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| S-EPMC7711809 | biostudies-literature

Proven COVID-19-associated pulmonary aspergillosis in patients with severe respiratory failure.

Project description:BackgroundAn increasing number of reports have described the COVID-19-associated pulmonary aspergillosis (CAPA) as being a further contributing factor to mortality. Based on a recent consensus statement supported by international medical mycology societies, it has been proposed to define CAPA as possible, probable, or proven on the basis of sample validity and thus diagnostic certainty. Considering current challenges associated with proven diagnoses, there is pressing need to study the epidemiology of proven CAPA.MethodsWe report the incidence of histologically diagnosed CAPA in a series of 45 consecutive COVID-19 laboratory-confirmed autopsies, performed at Padova University Hospital during the first and second wave of the pandemic. Clinical data, laboratory data and radiological features were also collected for each case.ResultsProven CAPA was detected in 9 (20%) cases, mainly in the second wave of the pandemic (7/17 vs. 2/28 of the first wave). The population of CAPA patients consisted of seven males and two females, with a median age of 74 years. Seven patients were admitted to the intensive care unit. All patients had at least two comorbidities, and concomitant lung diseases were detected in three cases.ConclusionWe found a high frequency of proven CAPA among patients with severe COVID-19 thus confirming at least in part the alarming epidemiological data of this important complication recently reported as probable CAPA.

| S-EPMC8446949 | biostudies-literature

Central nervous system Aspergillus quadrilineatus infection in a COVID-19 patient, a case report and literature review.

Project description:BackgroundViral pneumonia such as COVID-19-associated aspergillosis could increase susceptibility to fungal super-infections in critically ill patients.MethodsHere we report a pediatric case of Aspergillus quadrilineatus cerebral infection in a recently diagnosed COVID-19-positive patient underlying acute lymphocytic leukemia. Morphological, molecular methods, and sequencing were used to identify this emerging species.ResultsHistopathological examination showed a granulomatous necrotic area containing dichotomously branching septate hyphae indicating a presumptive Aspergillus structure. The species-level identity of isolate growing on brain biopsy culture was confirmed by PCR sequencing of the β-tubulin gene as A. quadrilineatus. Using the CLSI M38-A3 broth microdilution methodology, the in vitro antifungal susceptibility testing demonstrated 0.032 μg/mL MIC for posaconazole, caspofungin, and anidulafungin and 8 μg/mL against amphotericin B. A combination of intravenous liposomal amphotericin B and caspofungin therapy for 8 days did not improve the patient's condition. The patient gradually continued to deteriorate and expired.ConclusionsThis is the first COVID-19-associated cerebral aspergillosis due to A. quadrilineatus in a pediatric patient with acute lymphocytic leukemia. However, comprehensive screening studies are highly recommended to evaluate its frequency and antifungal susceptibility profiles. Before being recommended as first-line therapy in high-risk patients, more antifungal susceptibility data are needed.

| S-EPMC10681513 | biostudies-literature

Azole-Resistant COVID-19-Associated Pulmonary Aspergillosis in an Immunocompetent Host: A Case Report.

Project description:COVID-19-associated pulmonary aspergillosis (CAPA) is a recently described disease entity affecting patients with severe pulmonary abnormalities treated in intensive care units. Delays in diagnosis contribute to a delayed start of antifungal therapy. In addition, the emergence of resistance to triazole antifungal agents puts emphasis on early surveillance for azole-resistant Aspergillus species. We present a patient with putative CAPA due to Aspergillus fumigatus with identification of a triazole-resistant isolate during therapy. We underline the challenges faced in the management of these cases, the importance of early diagnosis and need for surveillance given the emergence of triazole resistance.

| S-EPMC7344504 | biostudies-literature

Aspergillus case report

Project description:Aspergillary rhinopharyngitis in an equine patient

| PRJEB46193 | ENA

Severe Recurrent COVID-Associated Pulmonary Aspergillosis: A Challenging Case.

Project description:We report a rare case of severe COVID-19-associated pulmonary aspergillosis presenting as invasive pulmonary aspergillosis and subsequently invasive tracheobronchial aspergillosis during hospitalization in a critically ill patient who developed a further Aspergillus infection after home discharge. He needed readmission to the ICU and mechanical ventilation. We therefore strongly encourage a high degree of attention to fungal complications, even after viral recovery and ICU discharge.

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