J 2022

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

ŠTINGL, Jan, Julie HYLMAROVÁ, Martina LENGEROVÁ, Jan MALÁSKA, Jan STAŠEK et. al.

Basic information

Original name

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

Authors

ŠTINGL, Jan (203 Czech Republic, belonging to the institution), Julie HYLMAROVÁ (203 Czech Republic, belonging to the institution), Martina LENGEROVÁ (203 Czech Republic, belonging to the institution), Jan MALÁSKA (203 Czech Republic, belonging to the institution) and Jan STAŠEK (203 Czech Republic, belonging to the institution)

Edition

Diagnostics, Basel, MDPI, 2022, 2075-4418

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.600

RIV identification code

RIV/00216224:14110/22:00126933

Organization unit

Faculty of Medicine

UT WoS

000847072100001

Keywords in English

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

Tags

International impact, Reviewed
Změněno: 5/4/2023 13:51, Mgr. Tereza Miškechová

Abstract

V originále

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.

Links

CZ.02.1.01/0.0/0.0/16_013/0001826, interní kód MU
(CEP code: EF16_013/0001826)
Name: CZECRIN_PRO PACIENTY - zavádění inovativních moderních terapií
Investor: Ministry of Education, Youth and Sports of the CR, Priority axis 1: Strengthening capacities for high-quality research
90128, large research infrastructures
Name: CZECRIN III