Disseminated Cryptococcus neoformans infection associated to COVID-19

Alegre-González, Diana; Herrera, Sabina; Bernal, Javier; Soriano, Álex; Bodro, Marta

doi:10.1016/j.mmcr.2021.10.001

Cited by 25 publications

(25 citation statements)

References 7 publications

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“…Of note, twelve previous cases of cryptococcosis in COVID-19 have been reported in the literature [12][13][14][15][16][17][18][19][20][21][22][23][24]: in seven of them [12,14,15,17,[19][20][21], as in our patient, blood stream infections were described; all but two (71%) had a poor outcome. In three of them, C. neoformans was isolated in CSF and in the other 2, on BAL culture.…”

Section: Discussionsupporting

confidence: 54%

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Disseminated Cryptococcosis Complicating Severe SARS-CoV-2 Infection

Lupia

Gaviraghi

Concialdi

et al. 2022

BioMed

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Opportunistic invasive fungal infections (IFI) have been described in severe SARS-CoV-2 infection. COVID-19-related cytokine storm, immune dysregulation and lymphopenia may increase IFI susceptibility in comorbid patients. We described the case of a 64-year-old man with respiratory failure due to SARS-CoV-2 infection complicated with disseminated cryptococosis. We analyzed the role played by the SARS-CoV-2-associated lymphopenia and the cumulative risk factors that lead to secondary infection by Cryptococcus neoformans, and its part in the dysregulation of the immunity response.

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Section: Discussionsupporting

confidence: 54%

“…In four cases, no traditional risk factors for cryptococcosis were identified. During the hospitalization, 92% of them (11/12) received high doses of corticosteroid [12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Cryptococcosis Complicating Severe SARS-CoV-2 Infection

Lupia

Gaviraghi

Concialdi

et al. 2022

BioMed

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“…Alegre-Gonzalez et al reported a case of a patient with disseminated cryptococcosis diagnosed on day 75 of COVID-19 infection in the setting of a prolonged course of both IV and oral steroids [10]. A case of cryptococcal meningoencephalitis with absent neurological symptoms is presented by Ghanem and Sivasubramanian [11].…”

Section: Discussionmentioning

confidence: 99%

The Emergence of Cryptococcemia in COVID-19 Infection: A Case Report

Gil¹,

Gil²,

Markou³

2021

Cureus

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Cryptococcus neoformans is a fungus that can cause pulmonary, central nervous system, and dermatological infections, especially in an immunocompromised patient. This is a case report of a patient, who was presumptively immunocompetent that developed isolated cryptococcemia while being treated for coronavirus disease 19 (COVID-19) infection. We report a case of a 59-year-old Hispanic man with a past medical history of hypertension, well-controlled diabetes mellitus, and class I obesity who was admitted for severe acute respiratory distress syndrome coronavirus 2 (SARS-COV-2) and subsequently was diagnosed with cryptococcal fungemia. The patient received 21 days of dexamethasone and during this period, blood and fungal cultures grew C. neoformans. The patient was alert and oriented, did not have focal neurological deficits or meningeal irritation signs; nonetheless, a lumbar puncture was attempted, but not successful. He was treated with intravenous amphotericin B for two weeks, followed by oral fluconazole for six weeks. Repeat blood cultures demonstrated clearance and he improved clinically. In conclusion, this case report describes the possibility of an association between the use of dexamethasone in COVID-19 patients and the development of cryptococcal fungemia. In the review of literature, rare case reports worldwide have discussed this topic. This is clinically challenging as the emergence of opportunistic infections in these debilitated hosts can be detrimental. Maintaining a high clinical suspicion for this opportunistic infection while treating COVID-19 patients is necessary to prevent further mortality associated with this pandemic.

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“…Coinfection of SARS-CoV-2 and Cryptococcus has been uncommonly reported but may reflect under-recognition. Clinical manifestations include cryptococcemia, lung infection, and meningoencephalitis [122][123][124]; infection may also be disseminated [125,126]. Cryptococcosis may occur concurrently or present after recovery from COVID-19 and even diagnosed post mortem [124].…”

Section: Cryptococcosismentioning

confidence: 99%

Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

Basile¹,

Halliday

Kok

et al. 2022

JoF

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Invasive fungal disease (IFD) associated with Coronavirus Disease 2019 (COVID-19) has focussed predominantly on invasive pulmonary aspergillosis. However, increasingly emergent are non-Aspergillus fungal infections including candidiasis, mucormycosis, pneumocystosis, cryptococcosis, and endemic mycoses. These infections are associated with poor outcomes, and their management is challenged by delayed diagnosis due to similarities of presentation to aspergillosis or to non-specific features in already critically ill patients. There has been a variability in the incidence of different IFDs often related to heterogeneity in patient populations, diagnostic protocols, and definitions used to classify IFD. Here, we summarise and address knowledge gaps related to the epidemiology, risks, diagnosis, and management of COVID-19-associated fungal infections other than aspergillosis.

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Disseminated Cryptococcus neoformans infection associated to COVID-19

Cited by 25 publications

References 7 publications

Disseminated Cryptococcosis Complicating Severe SARS-CoV-2 Infection

Disseminated Cryptococcosis Complicating Severe SARS-CoV-2 Infection

The Emergence of Cryptococcemia in COVID-19 Infection: A Case Report

Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

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