Agrawal Shruti, Phulware Ravi Hari
All India Institute of Medical Sciences, Department of Pathology & Laboratory Medicine, Rishikesh, Uttarakhand, India.
Autops Case Rep. 2021 Aug 20;11:e2021313. doi: 10.4322/acr.2021.313. eCollection 2021.
Viral or bacterial co-infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in the literature. However, the knowledge on Aspergillus co-infection among patients with coronavirus disease 2019 (COVID-19) is limited. COVID-19-associated pulmonary aspergillosis (CAPA) has been seen in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS), which has raised concerns about the worsening disease course of COVID-19 and increasing mortality. We describe a clinical case of CAPA infection and acute respiratory distress syndrome (ARDS) with a deathly outcome in a previously well, non-immunocompromised pregnant woman with intrauterine death of the fetus. Hence, we suggest that clinicians and pathologists keep alerting the possible occurrence of pulmonary aspergillosis in severe/critical COVID-19 patients, and aggressive investigations should be done to rule out the possibility of CAPA so that early treatment can be administrated.
文献中已报道了严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的病毒或细菌合并感染情况。然而,关于2019冠状病毒病(COVID-19)患者中曲霉合并感染的认识有限。在患有急性呼吸窘迫综合征(ARDS)的危重症COVID-19患者中已发现COVID-19相关肺曲霉病(CAPA),这引发了对COVID-19疾病进程恶化和死亡率增加的担忧。我们描述了一例CAPA感染和急性呼吸窘迫综合征(ARDS)的临床病例,该病例发生在一名先前健康、无免疫功能低下的孕妇身上,胎儿宫内死亡,最终导致死亡。因此,我们建议临床医生和病理学家应持续警惕重症/危重症COVID-19患者中可能发生的肺曲霉病,应积极进行检查以排除CAPA的可能性,从而能够尽早进行治疗。