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Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes direct damage to the pulmonary epithelium, enabling Aspergillus invasion. Rapid progression and high mortality of invasive aspergillosis have been reported. In the present study, we report a rare case of possible COVID-19-associated...

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Autores principales: Katsiari, Maria, Mavroidi, Angeliki, Palla, Eleftheria, Zourla, Konstantina, Alonistiotis, Theodoros, Ntorlis, Kyriakos, Nikolaou, Charikleia, Vrioni, Georgia, Tsakris, Athanasios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944507/
https://www.ncbi.nlm.nih.gov/pubmed/35326764
http://dx.doi.org/10.3390/antibiotics11030300
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author Katsiari, Maria
Mavroidi, Angeliki
Palla, Eleftheria
Zourla, Konstantina
Alonistiotis, Theodoros
Ntorlis, Kyriakos
Nikolaou, Charikleia
Vrioni, Georgia
Tsakris, Athanasios
author_facet Katsiari, Maria
Mavroidi, Angeliki
Palla, Eleftheria
Zourla, Konstantina
Alonistiotis, Theodoros
Ntorlis, Kyriakos
Nikolaou, Charikleia
Vrioni, Georgia
Tsakris, Athanasios
author_sort Katsiari, Maria
collection PubMed
description Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes direct damage to the pulmonary epithelium, enabling Aspergillus invasion. Rapid progression and high mortality of invasive aspergillosis have been reported. In the present study, we report a rare case of possible COVID-19-associated pulmonary aspergillosis (CAPA) caused by A. niger in a Greek patient. Diagnosis was based on ECMM/ISHAM specific criteria and the new algorithm “BM-AspICU” for the invasive pulmonary aspergillosis diagnostic strategy. The fungal isolate was recovered in a non-bronchoalveolar lavage (non-BAL) sample and its identification was performed by standard macroscopic and microscopic morphological studies. MALDI-TOF analysis confirmed the identification of A. niger. In addition, galactomannan antigen and Aspergillus real-time PCR testing were positive in the non-BAL sample, while in serum they proved negative. The A. niger isolate showed an MIC for fluconazole ≥128 μg/mL, for itraconazole and posaconazole 0.25 μg/mL, for voriconazole 0.5 μg/mL, for flucytosine 4 μg/mL, for amphotericin B 1 μg/mL, and for all echinocandins (caspofungin, anidulafungin, micafungin) >8 μg/mL. The patient was initially treated with voriconazole; amphotericin B was subsequently added, when a significant progression of cavitation was demonstrated on chest computed tomography. A. niger was not isolated in subsequent samples and the patient’s unfavorable outcome was attributed to septic shock caused by a pandrug-resistant Acinetobacter baumannii strain.
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spelling pubmed-89445072022-03-25 Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece Katsiari, Maria Mavroidi, Angeliki Palla, Eleftheria Zourla, Konstantina Alonistiotis, Theodoros Ntorlis, Kyriakos Nikolaou, Charikleia Vrioni, Georgia Tsakris, Athanasios Antibiotics (Basel) Case Report Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes direct damage to the pulmonary epithelium, enabling Aspergillus invasion. Rapid progression and high mortality of invasive aspergillosis have been reported. In the present study, we report a rare case of possible COVID-19-associated pulmonary aspergillosis (CAPA) caused by A. niger in a Greek patient. Diagnosis was based on ECMM/ISHAM specific criteria and the new algorithm “BM-AspICU” for the invasive pulmonary aspergillosis diagnostic strategy. The fungal isolate was recovered in a non-bronchoalveolar lavage (non-BAL) sample and its identification was performed by standard macroscopic and microscopic morphological studies. MALDI-TOF analysis confirmed the identification of A. niger. In addition, galactomannan antigen and Aspergillus real-time PCR testing were positive in the non-BAL sample, while in serum they proved negative. The A. niger isolate showed an MIC for fluconazole ≥128 μg/mL, for itraconazole and posaconazole 0.25 μg/mL, for voriconazole 0.5 μg/mL, for flucytosine 4 μg/mL, for amphotericin B 1 μg/mL, and for all echinocandins (caspofungin, anidulafungin, micafungin) >8 μg/mL. The patient was initially treated with voriconazole; amphotericin B was subsequently added, when a significant progression of cavitation was demonstrated on chest computed tomography. A. niger was not isolated in subsequent samples and the patient’s unfavorable outcome was attributed to septic shock caused by a pandrug-resistant Acinetobacter baumannii strain. MDPI 2022-02-23 /pmc/articles/PMC8944507/ /pubmed/35326764 http://dx.doi.org/10.3390/antibiotics11030300 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Katsiari, Maria
Mavroidi, Angeliki
Palla, Eleftheria
Zourla, Konstantina
Alonistiotis, Theodoros
Ntorlis, Kyriakos
Nikolaou, Charikleia
Vrioni, Georgia
Tsakris, Athanasios
Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title_full Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title_fullStr Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title_full_unstemmed Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title_short Possible COVID-19-Associated Pulmonary Aspergillosis Due to Aspergillus niger in Greece
title_sort possible covid-19-associated pulmonary aspergillosis due to aspergillus niger in greece
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944507/
https://www.ncbi.nlm.nih.gov/pubmed/35326764
http://dx.doi.org/10.3390/antibiotics11030300
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