A fatal case of COVID-19-associated invasive pulmonary aspergillosis

Yuto Iwanaga; Toshinori Kawanami; Kei Yamasaki; Hideki Sakakibara; Issei Ikushima; Hiroaki Ikegami; Masahiro Tahara; Kentaro Akata; Hiroshi Mukae; Kazuhiro Yatera

doi:10.1016/j.jiac.2021.03.024

A fatal case of COVID-19-associated invasive pulmonary aspergillosis

J Infect Chemother. 2021 Jul;27(7):1102-1107. doi: 10.1016/j.jiac.2021.03.024. Epub 2021 Apr 1.

Affiliations

¹ Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
² Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. Electronic address: yamasaki@med.uoeh-u.ac.jp.
³ Department of Respiratory Medicine, University Graduate School of Biomedical Sciences, Nagasaki City, Japan.

Abstract

A 79-year-old Japanese man with polymyalgia rheumatica was admitted to hospital with coronavirus disease (COVID-19). On admission, he was treated with ciclesonide inhalation, ivermectin, and meropenem. He was intubated 6 days after admission, and methylprednisolone therapy was initiated (1000 mg/day). Hypoxemia and chest radiographic findings temporarily improved. However, chest computed tomography showed bilateral ground-glass attenuations, multiple nodules, and consolidation. Aspergillus fumigatus was cultured from the tracheal aspirate and he was diagnosed with COVID-19-associated invasive pulmonary aspergillosis (CAPA) and treated with liposomal amphotericin B. However, he died 28 days after admission.

Keywords: Acute respiratory distress syndrome; COVID-19; COVID-19 associated invasive pulmonary aspergillosis.

Publication types

Case Reports

MeSH terms

Aged
Aspergillus fumigatus
COVID-19*
Humans
Invasive Pulmonary Aspergillosis* / diagnosis
Invasive Pulmonary Aspergillosis* / drug therapy
Male
SARS-CoV-2
Tomography, X-Ray Computed