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

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...

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Autores principales: Abdalla, Shiema, Almaslamani, Muna A., Hashim, Samar M., Ibrahim, Abdulsalam S., Omrani, Ali S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443053/
https://www.ncbi.nlm.nih.gov/pubmed/32864340
http://dx.doi.org/10.1016/j.idcr.2020.e00935
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author Abdalla, Shiema
Almaslamani, Muna A.
Hashim, Samar M.
Ibrahim, Abdulsalam S.
Omrani, Ali S.
author_facet Abdalla, Shiema
Almaslamani, Muna A.
Hashim, Samar M.
Ibrahim, Abdulsalam S.
Omrani, Ali S.
author_sort Abdalla, Shiema
collection PubMed
description 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.
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spelling pubmed-74430532020-08-24 Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature Abdalla, Shiema Almaslamani, Muna A. Hashim, Samar M. Ibrahim, Abdulsalam S. Omrani, Ali S. IDCases Article 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. Elsevier 2020-08-22 /pmc/articles/PMC7443053/ /pubmed/32864340 http://dx.doi.org/10.1016/j.idcr.2020.e00935 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Abdalla, Shiema
Almaslamani, Muna A.
Hashim, Samar M.
Ibrahim, Abdulsalam S.
Omrani, Ali S.
Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title_full Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title_fullStr Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title_full_unstemmed Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title_short Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature
title_sort fatal coronavirus disease 2019-associated pulmonary aspergillosis; a report of two cases and review of the literature
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443053/
https://www.ncbi.nlm.nih.gov/pubmed/32864340
http://dx.doi.org/10.1016/j.idcr.2020.e00935
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