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Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient
Cryptococcal superinfection is a rare but potentially fatal complication, especially if its detection and subsequent treatment are delayed. Histopathological findings of pulmonary parenchyma from a deceased patient with these complications were acquired. Quite interestingly, only a minimal inflammat...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406651/ https://www.ncbi.nlm.nih.gov/pubmed/36010294 http://dx.doi.org/10.3390/diagnostics12081944 |
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author | Štingl, Jan Hylmarová, Julie Lengerová, Martina Maláska, Jan Stašek, Jan |
author_facet | Štingl, Jan Hylmarová, Julie Lengerová, Martina Maláska, Jan Stašek, Jan |
author_sort | Štingl, Jan |
collection | PubMed |
description | Cryptococcal superinfection is a rare but potentially fatal complication, especially if its detection and subsequent treatment are delayed. Histopathological findings of pulmonary parenchyma from a deceased patient with these complications were acquired. Quite interestingly, only a minimal inflammatory reaction could be seen in an individual with no previously known immune suppression, indicating a disturbance of the immune system. This finding was well in concordance with the described changes in cellular immunity in COVID-19. We report the case of a 60 year old male with critical coronavirus disease 2019 (COVID-19) complicated by cryptococcal pneumonia and multiorgan failure. Both X-ray and CT scans revealed lung infiltrates corresponding with COVID-19 infection early after the onset of symptoms. Despite receiving standard treatment, the patient progressed into multiple organ failure, requiring mechanical ventilation, circulatory support, and haemodialysis. Cryptococcus neoformans was detected by subsequent BAL, and specific antifungal treatment was instituted. His clinical status deteriorated despite all treatment, and he died of refractory circulatory failure after 21 days from hospital admission. Histopathological findings confirmed severe diffuse alveolar damage (DAD) caused by COVID-19 and cryptococcal pneumonia. Timely diagnosis of cryptococcal superinfection may be challenging; therefore, PCR panels detecting even uncommon pathogens should be implemented while taking care of critical COVID-19 patients. |
format | Online Article Text |
id | pubmed-9406651 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94066512022-08-26 Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient Štingl, Jan Hylmarová, Julie Lengerová, Martina Maláska, Jan Stašek, Jan Diagnostics (Basel) Interesting Images Cryptococcal superinfection is a rare but potentially fatal complication, especially if its detection and subsequent treatment are delayed. Histopathological findings of pulmonary parenchyma from a deceased patient with these complications were acquired. Quite interestingly, only a minimal inflammatory reaction could be seen in an individual with no previously known immune suppression, indicating a disturbance of the immune system. This finding was well in concordance with the described changes in cellular immunity in COVID-19. We report the case of a 60 year old male with critical coronavirus disease 2019 (COVID-19) complicated by cryptococcal pneumonia and multiorgan failure. Both X-ray and CT scans revealed lung infiltrates corresponding with COVID-19 infection early after the onset of symptoms. Despite receiving standard treatment, the patient progressed into multiple organ failure, requiring mechanical ventilation, circulatory support, and haemodialysis. Cryptococcus neoformans was detected by subsequent BAL, and specific antifungal treatment was instituted. His clinical status deteriorated despite all treatment, and he died of refractory circulatory failure after 21 days from hospital admission. Histopathological findings confirmed severe diffuse alveolar damage (DAD) caused by COVID-19 and cryptococcal pneumonia. Timely diagnosis of cryptococcal superinfection may be challenging; therefore, PCR panels detecting even uncommon pathogens should be implemented while taking care of critical COVID-19 patients. MDPI 2022-08-12 /pmc/articles/PMC9406651/ /pubmed/36010294 http://dx.doi.org/10.3390/diagnostics12081944 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 | Interesting Images Štingl, Jan Hylmarová, Julie Lengerová, Martina Maláska, Jan Stašek, Jan Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title | Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title_full | Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title_fullStr | Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title_full_unstemmed | Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title_short | Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient |
title_sort | cryptococcal pneumonia: an unusual complication in a covid-19 patient |
topic | Interesting Images |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9406651/ https://www.ncbi.nlm.nih.gov/pubmed/36010294 http://dx.doi.org/10.3390/diagnostics12081944 |
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