COVID-19 Associated Pulmonary Aspergillosis: A Case Series

Authors

  • Mira Yulianti Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Christian Johan Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Eric Daniel Tenda Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Gurmeet Singh Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Herikurniawan Herikurniawan Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • I Putu Eka Krisnha Wijaya Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Keywords:

Aspergillosis, Aspergillus, COVID-19, COVID-19-associated pulmonary aspergillosis (CAPA), invasive pulmonary aspergillosis (IPA)

Abstract

Coronavirus disease 2019 (COVID-19) has been a worldwide pandemic with several problems, one of which is the lack of definitive treatment. COVID-19-associated pulmonary aspergillosis (CAPA), the presence of invasive pulmonary aspergillosis (IPA) in COVID-19 patients, is one of the concerning secondary infections associated with higher mortality and worse clinical outcomes. Diagnosing CAPA may be challenging due to the possible absence of classic host factors and clinical symptoms or obscured radiological findings. We described two CAPA cases, which were suspected due to persistent respiratory failure despite standard treatment of COVID-19 with additional therapies and antimicrobial agents for secondary infections, eventually diagnosed with serum galactomannan testing. Clinical conditions of both patients improved significantly after the administration of voriconazole. This case series emphasizes the importance of being aware of clinical suspicions indicating CAPA followed by galactomannan testing as a relatively fast, noninvasive test for its diagnosis, which leads to appropriate antifungal treatment.

Author Biographies

Mira Yulianti, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Medical staff of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Christian Johan, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Research Assistant of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Eric Daniel Tenda, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Medical staff of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Gurmeet Singh, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Head of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Herikurniawan Herikurniawan, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Medical staff of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

I Putu Eka Krisnha Wijaya, Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Medical staff of the Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

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Published

2022-07-07

How to Cite

Yulianti, M., Johan, C., Tenda, E. D., Singh, G., Herikurniawan, H., & Wijaya, I. P. E. K. (2022). COVID-19 Associated Pulmonary Aspergillosis: A Case Series. Acta Medica Indonesiana, 54(2), 292. Retrieved from https://actamedindones.org/index.php/ijim/article/view/1996