Department of Infectious Disease, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ocul Immunol Inflamm. 2023 Aug;31(6):1291-1294. doi: 10.1080/09273948.2023.2188224. Epub 2023 Mar 23.
Coronavirus disease 2019 (COVID-19) is associated with immune system dysfunction and makes patients vulnerable to opportunistic infections. This report presents a patient with a history of COVID-19, suffering from opportunistic infections.
We reported a 64-year-old man complaining of progressive visual loss in his left eye, who had previously been hospitalized for three weeks due to COVID-19. In the ophthalmologic assessment, large foci of dense subretinal and intraretinal infiltrations involving the macula were observed (compatible with endogenous fungal endophthalmitis). Real-time PCR result of intraocular fluid was positive for Candida spp. During subsequent hospitalization, the patient also suffered from fever and productive coughs (manifestations of pneumonia caused by Aspergillus fumigatus and ). In response to antibiotic therapy, the fever and coughs subsided, and the ocular examination revealed a dramatic decrease in the size of retinal infiltrations.
In patients with severe COVID-19, long-term ICU admission and immunosuppressive drugs lead to immune system dysfunction and make the patient more susceptible to opportunistic infections. Consequently, fungal pathogens such as Aspergillus, , and Candida spp. may cause infection in different body organs. Thus, clinicians should be alert and have clinical suspicion to diagnose accurately and manage patients accordingly.
2019 年冠状病毒病(COVID-19)与免疫系统功能障碍有关,使患者易患机会性感染。本报告介绍了一位有 COVID-19 病史的患者,患有机会性感染。
我们报告了一位 64 岁男性,因 COVID-19 住院三周后,左眼视力逐渐下降。眼科评估发现,大的密集的视网膜下和视网膜内浸润病灶累及黄斑(符合内源性真菌性眼内炎)。眼内液的实时 PCR 结果为 Candida spp. 阳性。随后住院期间,患者还出现发热和咳痰(曲霉菌引起的肺炎表现)。针对抗生素治疗,发热和咳嗽缓解,眼部检查显示视网膜浸润灶明显缩小。
在重症 COVID-19 患者中,长期 ICU 住院和免疫抑制药物导致免疫系统功能障碍,使患者更容易发生机会性感染。因此,曲霉菌、毛霉菌和 Candida spp. 等真菌病原体可能导致不同器官的感染。因此,临床医生应保持警惕并具有临床怀疑,以准确诊断并相应地进行治疗。