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Am J Trop Med Hyg . Case Report: Chronic Cavitatory Pulmonary Aspergillosis after COVID-19

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  • Am J Trop Med Hyg . Case Report: Chronic Cavitatory Pulmonary Aspergillosis after COVID-19


    Am J Trop Med Hyg


    . 2021 Nov 24;tpmd210701.
    doi: 10.4269/ajtmh.21-0701. Online ahead of print.
    Case Report: Chronic Cavitatory Pulmonary Aspergillosis after COVID-19


    Sheetal Chaurasia 1 , Manjunath Thimmappa 2 , Saurav Chowdhury 1



    Affiliations

    Abstract

    Chronic pulmonary aspergillosis can present in four distinct clinical syndromes, one of which is chronic cavitary pulmonary aspergillosis (CCPA). CCPA is generally associated with a mildly immunosuppressed state or, in immunocompetent patients, with structural lung damage. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with reactivation of previous quiescent infections such as tuberculosis and invasive fungal infections, but CCPA in a patient with COVID-19 is rarely reported. Here we present the case of a 57-year-old man with CCPA associated with COVID-19 infection in whom latent aspergilloma was most likely activated after SARS-CoV-2 infection. The patient presented with severe COVID and, after initial response to treatment, started to deteriorate due to reactivation of latent aspergilloma to a more aggressive CCPA form. After confirmation of the diagnosis, the patient was initiated on treatment with voriconazole. He showed a good response to treatment with clinicoradiological response. This case also depicts one of the common causes of clinical deterioration in otherwise recovering COVID-19 patients.


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