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Fatal Invasive Pulmonary Aspergillosis in Covid-19 Patient With Acute Myeloid Leukemia in Iran Publisher Pubmed



Nasri E1 ; Shoaei P2 ; Vakili B1 ; Mirhendi H3 ; Sadeghi S1, 4 ; Hajiahmadi S5 ; Sadeghi A4 ; Vaezi A6 ; Badali H6, 7 ; Fakhim H1
Authors
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Authors Affiliations
  1. 1. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Research Core Facility Lab, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
  7. 7. Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States

Source: Mycopathologia Published:2020


Abstract

Although patients with severe immunodeficiency and hematological malignancies has been considered at highest risk for invasive fungal infection, patients with severe pneumonia due to influenza, and severe acute respiratory syndrome coronavirus (SARS-CoV) are also at a higher risk of developing invasive pulmonary aspergillosis (IPA). Recently, reports of IPA have also emerged among SARS-CoV-2 infected patients admitted to intensive care units (ICUs). Here, we report a fatal case of probable IPA in an acute myeloid leukemia patient co-infected with SARS-CoV-2 and complicated by acute respiratory distress syndrome (ARDS). Probable IPA is supported by multiple pulmonary nodules with ground glass opacities which indicate halo sign and positive serum galactomannan results. Screening studies are needed to evaluate the prevalence of IPA in immunocompromised patients infected with SARS-CoV-2. Consequently, testing for the presence of Aspergillus in lower respiratory secretions and galactomannan in consecutive serum samples of COVID-19 patients with timely and targeted antifungal therapy based on early clinical suspicion of IPA are highly recommended. © 2020, Springer Nature B.V.
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