Fatal VAP-related pulmonary aspergillosis by Aspergillus niger in a positive COVID-19 patient

Laura Trovato; Maddalena Calvo; Giuseppe Migliorisi; Marinella Astuto; Francesco Oliveri; Salvatore Oliveri

doi:10.1016/j.rmcr.2021.101367

Fatal VAP-related pulmonary aspergillosis by Aspergillus niger in a positive COVID-19 patient

Respir Med Case Rep. 2021:32:101367. doi: 10.1016/j.rmcr.2021.101367. Epub 2021 Feb 18.

Authors

Laura Trovato^{1

2}, Maddalena Calvo¹, Giuseppe Migliorisi¹, Marinella Astuto³, Francesco Oliveri³, Salvatore Oliveri^{1

2}

Affiliations

¹ U.O.C. Laboratory Analysis Unit, A.O.U. "Policlinico-Vittorio Emanuele", Via S. Sofia 78, Catania, 95123, Italy.
² Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, Catania, 95123, Italy.
³ Department of Anesthesia and Intensive Care, A.O.U. "Policlinico -Vittorio Emanuele", Via S. Sofia 78, Catania, 95123, Italy.

Abstract

Invasive pulmonary aspergillosis, known as a complication in patients with severe respiratory syndromes, recently showed a correlation with COVID-19 pneumonia, and the clinical characteristics of COVID-19 associated pulmonary aspergillosis (CAPA) have been described. Unfortunately, infections by the Aspergillus genus are often diagnosed in post-mortem time, because of diagnostic delays and a rapid worsening of respiratory conditions. Literature data document, in fact, only few cases of COVID-19 Aspergillus niger coinfection. The aim of this study was to describe a case of a VAP-related probable pulmonary aspergillosis by Aspergillus niger in a COVID-19 patient. Despite the definition of fungal etiology and the rapid administration of antifungal therapy, the patient died while on ventilator support because of severe respiratory impairment.

Keywords: Aspergillus niger; C-PAP, Continuous Positive Airway Pressure; Coinfection; GM, Aspergillus antigen galactomannan; ICU, Intensive Care Unit; IPA, Invasive pulmonary aspergillosis; Pulmonary aspergillosis; SARS-CoV-2; VAP, ventilator associated pneumonia; Ventilator-associated pneumonia.

Publication types

Case Reports