Uncommon presentation of allergic bronchopulmonary aspergillosis during the COVID-19 lockdown: a case report

Savi, Daniela; Valente, Giada; Iacovelli, Alessandra; Olmati, Federica; Bezzi, Mario; Palange, Paolo

doi:10.1186/s12890-020-01373-7

Cited by 7 publications

(10 citation statements)

References 9 publications

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“… Distribution ( a ) and co-occurrence ( b ) of fungal species across randomly selected 50 case studies, prospective and retrospective published reports on fungal co-infections in hospitalized COVID-19 patients [ 5 , 7 , 9 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ] (also see Supplementary Table S1 ). Searches were done on PubMed (Medline) and Google Scholar using query terms such as “Co-infections”, “coinfections”, “fungi” or “Fungal infections” in combination with either “COVID-19” or “SARS-CoV-2”.…”

Section: Figurementioning

confidence: 99%

Risk Factors for Fungal Co-Infections in Critically Ill COVID-19 Patients, with a Focus on Immunosuppressants

Ezeokoli

Gcilitshana

Pohl

2021

JoF

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Severe cases of coronavirus disease 2019 (COVID-19) managed in the intensive care unit are prone to complications, including secondary infections with opportunistic fungal pathogens. Systemic fungal co-infections in hospitalized COVID-19 patients may exacerbate COVID-19 disease severity, hamper treatment effectiveness and increase mortality. Here, we reiterate the role of fungal co-infections in exacerbating COVID-19 disease severity as well as highlight emerging trends related to fungal disease burden in COVID-19 patients. Furthermore, we provide perspectives on the risk factors for fungal co-infections in hospitalized COVID-19 patients and highlight the potential role of prolonged immunomodulatory treatments in driving fungal co-infections, including COVID-19-associated pulmonary aspergillosis (CAPA), COVID-19-associated candidiasis (CAC) and mucormycosis. We reiterate the need for early diagnosis of suspected COVID-19-associated systemic mycoses in the hospital setting.

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Section: Figurementioning

confidence: 99%

Risk Factors for Fungal Co-Infections in Critically Ill COVID-19 Patients, with a Focus on Immunosuppressants

Ezeokoli

Gcilitshana

Pohl

2021

JoF

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“…Ateş, kilo kaybı, genel durumun bozulması, hemoptizi, göğüs ağrısı ve gece terlemesi gibi diğer semptomlarla ilişkili olabilir. [8] Sarımsı yeşil mukus sekresyonlarının ekspektorasyonu ABPA'nın karakteristiğidir ve bizim olgumuzda olduğu gibi olguların yarısında görülebilir. [9] ABPA tanısını koyan tek bir test yoktur.…”

Section: Discussionunclassified

Allerjik Bronkopulmoner Aspergillozis (Bir Olgu Sunumu)

Bozkurt¹

2023

IGH

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Allergic bronchopulmonary aspergillosis (ABPA) is a fungal infection of the lung caused by a hypersensitivity reaction to Aspergillus fumigatus antigens after colonization of the airways. It predominantly affects patients with bronchial asthma and cystic fibrosis. ABPA is seen in 1-7.6% of asthma cases. We performed a bronchoscopy on our 72-year-old male patient with asthma diagnosis, who had shortness of breath and whose pneumonia had radiological progression with broad--spectrum antibiotic therapy. A. fumigatus was detected in the bronchoalveolar lavage sample. We achieved clinical and radiological improvement with systemic steroid and amphotericin B treatment. We present our patient in light of the literature due to its rarity.

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“…Moreover, some clinical presentations are confusing such as the case reported by Savi and al. and where the diagnosis of ABPA was established in a previously healthy male ( 15 ). Also, in a nationwide Japan survey, 19% of patients diagnosed with ABPA had no medical history of asthma ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Allergic Bronchopulmonary Aspergillosis Revealing Asthma

et al. 2021

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Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder caused by hypersensitivity to Aspergillus which colonizes the airways of patients with asthma and cystic fibrosis. Its diagnosis could be difficult in some cases due to atypical presentations especially when there is no medical history of asthma. Treatment of ABPA is frequently associated to side effects but cumulated drug toxicity due to different molecules is rarely reported. An accurate choice among the different available molecules and effective on ABPA is crucial. We report a case of ABPA in a woman without a known history of asthma. She presented an acute bronchitis with wheezing dyspnea leading to an acute respiratory failure. She was hospitalized in the intensive care unit. The bronchoscopy revealed a complete obstruction of the left primary bronchus by a sticky greenish material. The culture of this material isolated Aspergillus fumigatus and that of bronchial aspiration fluid isolated Pseudomonas aeruginosa. The diagnosis of ABPA was based on elevated eosinophil count, the presence of specific IgE and IgG against Aspergillus fumigatus and left segmental collapse on chest computed tomography. The patient received an inhaled treatment for her asthma and a high dose of oral corticosteroids for ABPA. Her symptoms improved but during the decrease of corticosteroids, the patient presented a relapse. She received itraconazole in addition to corticosteroids. Four months later, she presented a drug-induced hepatitis due to itraconazole which was immediately stopped. During the monitoring of her asthma which was partially controlled, the patient presented an aseptic osteonecrosis of both femoral heads that required surgery. Nine months after itraconazole discontinuation, she presented a second relapse of her ABPA. She received voriconazole for nine months associated with a low dose of systemic corticosteroid therapy with an improvement of her symptoms. After discontinuation of antifungal treatment, there was no relapse for one year follow-up.

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Uncommon presentation of allergic bronchopulmonary aspergillosis during the COVID-19 lockdown: a case report

Cited by 7 publications

References 9 publications

Risk Factors for Fungal Co-Infections in Critically Ill COVID-19 Patients, with a Focus on Immunosuppressants

Risk Factors for Fungal Co-Infections in Critically Ill COVID-19 Patients, with a Focus on Immunosuppressants

Allerjik Bronkopulmoner Aspergillozis (Bir Olgu Sunumu)

Case Report: Allergic Bronchopulmonary Aspergillosis Revealing Asthma

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