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新型冠状病毒肺炎相关肺曲霉病后发生肾曲霉病:一例报告

Renal aspergillosis after COVID-19-associated pulmonary aspergillosis: A case report.

作者信息

Ghasemian Roya, Vahedi Larijani Lale, Rasouli Kimia, Hedayati Mohammad Taghi, Tavakol Chanour, Heydari Keyvan, Zalpoor Hamidreza, Hoseini Aref

机构信息

Department of Infectious Disease Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences Sari Iran.

Department of Pathology, School of Medicine Mazandaran University of Medical Sciences Sari Iran.

出版信息

Clin Case Rep. 2023 Sep 7;11(9):e7882. doi: 10.1002/ccr3.7882. eCollection 2023 Sep.

Abstract

KEY CLINICAL MESSAGE

Renal aspergillosis is a rare condition and this case the first case of Renal aspergillosis reported after COVID-19-associated pulmonary aspergillosis. Renal symptoms should arise clinical suspicion to renal involvement that happened as a result of hematogenous spreading of pulmonary aspergillosis.

ABSTRACT

Secondary fungal infections are among the most significant complications that can arise after COVID-19 and have the potential to lead to a high rate of morbidity and mortality. As COVID-19 primarily involves the airway, the majority of fungal infections reported have been related to the respiratory system. However, renal aspergillosis that we have reported is a rare condition that also can occur. A 67-year-old man was referred to our hospital and admitted as a COVID-19 patient. After the initial recovery, he experienced a recurrence of fever accompanied by a productive cough. The histopathological studies were conducted on the sputum and bronchoalveolar lavage samples, which revealed the presence of . We treated the patient with voriconazole and the patient was discharged after a period of time. However, after approximately 6 months, he returned to the hospital with a fever and abdominal pain. We started a fever workup. Two new hypoechoic abscess-like masses were spotted in the right kidney in the ultrasonography (U/S) and the direct molecular studies of the biopsy sample obtained under U/S guidance identified . Although renal aspergillosis is a rare condition, it should not be overlooked, especially in patients with severe COVID-19 and pulmonary aspergillosis, as these conditions can lead to renal aspergillosis, which may present with symptoms such as abdominal pain with fever. Therefore, it is necessary to perform radiological and histopathological studies when renal aspergillosis is suspected.

摘要

关键临床信息

肾曲霉病是一种罕见疾病,该病例是首例在新型冠状病毒肺炎相关肺曲霉病后报告的肾曲霉病病例。肾脏症状应引起对因肺曲霉病血行播散导致肾脏受累的临床怀疑。

摘要

继发性真菌感染是新型冠状病毒肺炎后可能出现的最严重并发症之一,有可能导致高发病率和死亡率。由于新型冠状病毒肺炎主要累及气道,报告的大多数真菌感染都与呼吸系统有关。然而,我们报告的肾曲霉病是一种也可能发生的罕见疾病。一名67岁男性被转诊至我院并作为新型冠状病毒肺炎患者入院。初始康复后,他出现发热复发并伴有咳痰。对痰液和支气管肺泡灌洗样本进行了组织病理学研究,结果显示存在……。我们用伏立康唑治疗该患者,一段时间后患者出院。然而,大约6个月后,他因发热和腹痛再次入院。我们开始进行发热检查。超声检查(U/S)在右肾发现两个新的低回声脓肿样肿块,在超声引导下获取的活检样本的直接分子研究确定了……。尽管肾曲霉病是一种罕见疾病,但不应被忽视,尤其是在患有严重新型冠状病毒肺炎和肺曲霉病的患者中,因为这些情况可能导致肾曲霉病,其可能表现为发热伴腹痛等症状。因此,当怀疑肾曲霉病时,有必要进行放射学和组织病理学研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8214/10485246/d51ec3da9a12/CCR3-11-e7882-g002.jpg

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