Imoto Waki, Himura Hoshi, Matsuo Kenji, Kawata Sae, Kiritoshi Ayako, Deguchi Ryo, Miyashita Masahiro, Kaga Shinichiro, Noda Tomohiro, Yamamoto Katsumi, Yamada Koichi, Uchida Kenichiro, Nishimura Tetsuro, Yamamoto Hiromasa, Mizobata Yasumitsu, Kakeya Hiroshi
Department of Infection Control Science, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Respiratory Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Trauma and Critical Care Center, Osaka City University Hospital, Osaka, Japan.
J Infect Chemother. 2021 Jun;27(6):911-914. doi: 10.1016/j.jiac.2021.02.026. Epub 2021 Feb 25.
CAPA (COVID-19 associated pulmonary aspergillosis) is an important complication of COVID-19. It has been reported that the incidence of CAPA is as high as 19%-33% worldwide. However, its onset has not been reported in Japan. A 72-year-old Japanese man was diagnosed with COVID-19 and was transferred to our hospital due to deterioration of respiratory condition. Treatment with remdesivir, dexamethasone (DEXA), and antibiotics was performed under mechanical ventilation. Although the condition improved temporarily, a new shadow appeared in the lung, and Aspergillus fumigatus was cultured from sputum. The patient was clinically diagnosed with CAPA and treated with voriconazole. However, his progress deteriorated and he died. High-risk COVID-19 patients should be tested for Aspergillus to ensure early diagnosis of CAPA.
新型冠状病毒肺炎相关肺曲霉病（CAPA）是新型冠状病毒肺炎（COVID-19）的一种重要并发症。据报道，全球CAPA的发病率高达19%-33%。然而，日本尚未有其发病情况的报道。一名72岁的日本男性被诊断为COVID-19，因呼吸状况恶化被转至我院。在机械通气的情况下，使用瑞德西韦、地塞米松（DEXA）和抗生素进行治疗。尽管病情暂时有所改善，但肺部出现了新的阴影，痰培养出烟曲霉。该患者临床诊断为CAPA，并接受伏立康唑治疗。然而，他的病情恶化，最终死亡。高危COVID-19患者应进行曲霉检测，以确保CAPA的早期诊断。
