Covid-19 associated pulmonary aspergillosis withextensive cavitary pneumonia: A case report

Abstract

Covid-19 associated pulmonary aspergillosis (CAPA) is a newentity and is associated with high morbidity and mortality. Covid-19 is a pro-inflammatory and immunosuppressive disease,provoking fungal infections, especially by Aspergillus species. We describe the case of a critically ill Covid-19 female patient,who was diagnosed with CAPA infection and acute respiratorydistress syndrome (ARDS). She was given intravenousRemdesivir. Her chest X-ray a few days after admission showedmultiple cavities. Her condition initially improved butdeteriorated again, with worsening hypoxia and pneumothoraxand multiple cavitary lesions on HRCT of the chest. Despiteoptimal treatment, she could not recover. Interestingly, she hadno predisposing risk factor for pulmonary aspergillosis, such aschronic lung disease, diabetes or use of immunosuppressantssuch as Tocilizumab. CAPA is an emerging entity with worsening hypoxia, and failureto improve can be an early sign. Early identification andtreatment can improve survival and outcomes in Covid-19patients.