tetano
Editor, Senior Moderator
Intern Med J
. 2021 Dec;51(12):2129-2132.
doi: 10.1111/imj.15602.
Invasive pulmonary aspergillosis in critically ill patients with COVID-19 in Australia: implications for screening and treatment
Shio Yen Tio[SUP] 1 2 3 [/SUP], Eloise Williams[SUP] 4 [/SUP], Leon J Worth[SUP] 2 3 [/SUP], Adam M Deane[SUP] 5 [/SUP], Katherine Bond[SUP] 4 [/SUP], Monica A Slavin[SUP] 1 2 3 [/SUP], Joe Sasadeusz[SUP] 1 [/SUP]
Affiliations
Abstract
We report four cases of invasive pulmonary aspergillus co-infection in patients with coronavirus disease 2019 (COVID-19) infection and acute respiratory distress syndrome requiring intensive care unit (ICU) admission. Aspergillus fumigatus and Aspergillus terreus were isolated, with early infection onset following ICU admission. Clinicians should be aware of invasive pulmonary aspergillosis in ICU patients with COVID-19 infection, particularly those receiving dexamethasone. We propose screening of these high-risk patients with twice-weekly fungal culture from tracheal aspirate and, if feasible, Aspergillus polymerase chain reaction. Diagnosis is challenging and antifungal treatment should be considered in critically ill patients who have new or worsening pulmonary changes on chest imaging and mycological evidence of infection.
Keywords: COVID-19; COVID-19-associated pulmonary aspergillosis; acute respiratory distress syndrome; dexamethasone; voriconazole.
. 2021 Dec;51(12):2129-2132.
doi: 10.1111/imj.15602.
Invasive pulmonary aspergillosis in critically ill patients with COVID-19 in Australia: implications for screening and treatment
Shio Yen Tio[SUP] 1 2 3 [/SUP], Eloise Williams[SUP] 4 [/SUP], Leon J Worth[SUP] 2 3 [/SUP], Adam M Deane[SUP] 5 [/SUP], Katherine Bond[SUP] 4 [/SUP], Monica A Slavin[SUP] 1 2 3 [/SUP], Joe Sasadeusz[SUP] 1 [/SUP]
Affiliations
- PMID: 34939293
- DOI: 10.1111/imj.15602
Abstract
We report four cases of invasive pulmonary aspergillus co-infection in patients with coronavirus disease 2019 (COVID-19) infection and acute respiratory distress syndrome requiring intensive care unit (ICU) admission. Aspergillus fumigatus and Aspergillus terreus were isolated, with early infection onset following ICU admission. Clinicians should be aware of invasive pulmonary aspergillosis in ICU patients with COVID-19 infection, particularly those receiving dexamethasone. We propose screening of these high-risk patients with twice-weekly fungal culture from tracheal aspirate and, if feasible, Aspergillus polymerase chain reaction. Diagnosis is challenging and antifungal treatment should be considered in critically ill patients who have new or worsening pulmonary changes on chest imaging and mycological evidence of infection.
Keywords: COVID-19; COVID-19-associated pulmonary aspergillosis; acute respiratory distress syndrome; dexamethasone; voriconazole.