4.6 Editorial Material

Cryptococcal Pneumonia: An Unusual Complication in a COVID-19 Patient

期刊

DIAGNOSTICS
卷 12, 期 8, 页码 -

出版社

MDPI
DOI: 10.3390/diagnostics12081944

关键词

Cryptococcus; COVID-19; SARS-CoV-2; fungal superinfection

资金

  1. MEYS, RI CZECRIN [LM2018128]
  2. ERDF [CZ.02.1.01/0.0/0.0/16_013/0001826]
  3. MH CZ-DRO [65269705, MH CZ-NU22-B-122]

向作者/读者索取更多资源

Cryptococcal superinfection is a rare but potentially fatal complication, especially if its detection and subsequent treatment are delayed. This case report highlights the disturbance of the immune system in a patient with no previously known immune suppression, which is consistent with the changes observed in cellular immunity in COVID-19. Despite receiving standard treatment, the patient's condition deteriorated and eventually resulted in death.
Cryptococcal superinfection is a rare but potentially fatal complication, especially if its detection and subsequent treatment are delayed. Histopathological findings of pulmonary parenchyma from a deceased patient with these complications were acquired. Quite interestingly, only a minimal inflammatory reaction could be seen in an individual with no previously known immune suppression, indicating a disturbance of the immune system. This finding was well in concordance with the described changes in cellular immunity in COVID-19. We report the case of a 60 year old male with critical coronavirus disease 2019 (COVID-19) complicated by cryptococcal pneumonia and multiorgan failure. Both X-ray and CT scans revealed lung infiltrates corresponding with COVID-19 infection early after the onset of symptoms. Despite receiving standard treatment, the patient progressed into multiple organ failure, requiring mechanical ventilation, circulatory support, and haemodialysis. Cryptococcus neoformans was detected by subsequent BAL, and specific antifungal treatment was instituted. His clinical status deteriorated despite all treatment, and he died of refractory circulatory failure after 21 days from hospital admission. Histopathological findings confirmed severe diffuse alveolar damage (DAD) caused by COVID-19 and cryptococcal pneumonia. Timely diagnosis of cryptococcal superinfection may be challenging; therefore, PCR panels detecting even uncommon pathogens should be implemented while taking care of critical COVID-19 patients.

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