He Liu, Wang Wei, Cai Danyan, Zhang Xiaoshan, Tan Xinyuan
Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, 999077, China.
PCCM, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.
Mycopathologia. 2025 Jul 30;190(5):67. doi: 10.1007/s11046-025-00971-5.
COVID-19-associated pulmonary aspergillosis (CAPA) significantly exacerbates the clinical outcomes of COVID-19 patients, contributing to heightened mortality. Aspergillus tracheobronchitis, a manifestation of invasive pulmonary aspergillosis, specifically involves the tracheobronchial tree. According to the 2020 European Confederation of Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) consensus criteria, airway biopsy via bronchoscopy is the definitive method for CAPA diagnosis, underscoring its critical role in the management of COVID-19 patients. This case report describes an elderly male patient with COVID-19 who presented with extensive pseudomembranous involvement of the tracheobronchial tree, identified through bronchoscopy. The pseudomembrane, spanning from the glottis to the bronchi and characterized by its yellow-white translucency, was removed. Subsequent pathological examination and next-generation sequencing confirmed an Aspergillus infection. Despite the initiation of antifungal therapy, the patient's condition deteriorated, leading to his death.
新型冠状病毒肺炎相关肺曲霉病（CAPA）显著恶化新型冠状病毒肺炎患者的临床结局，导致死亡率升高。曲霉气管支气管炎是侵袭性肺曲霉病的一种表现，特别累及气管支气管树。根据2020年欧洲医学真菌学联合会/国际人类和动物真菌学学会（ECMM/ISHAM）共识标准，通过支气管镜进行气道活检是CAPA诊断的金标准方法，突显了其在新型冠状病毒肺炎患者管理中的关键作用。本病例报告描述了一名患有新型冠状病毒肺炎的老年男性患者，通过支气管镜检查发现气管支气管树广泛存在假膜性病变。该假膜从声门延伸至支气管，呈黄白色半透明状，已被清除。随后的病理检查和二代测序证实为曲霉感染。尽管开始了抗真菌治疗，但患者病情仍恶化并最终死亡。
