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Case Reports
. 2020 Jun 6;6(2):79.
doi: 10.3390/jof6020079.

Azole-Resistant COVID-19-Associated Pulmonary Aspergillosis in an Immunocompetent Host: A Case Report

Eelco F J Meijer  1   2   3 , Anton S M Dofferhoff  3   4 , Oscar Hoiting  5 , Jochem B Buil  1   2 , Jacques F Meis  1   2   3   6
Affiliations
Case Reports

Azole-Resistant COVID-19-Associated Pulmonary Aspergillosis in an Immunocompetent Host: A Case Report

Eelco F J Meijer et al. J Fungi (Basel). .

Abstract

COVID-19-associated pulmonary aspergillosis (CAPA) is a recently described disease entity affecting patients with severe pulmonary abnormalities treated in intensive care units. Delays in diagnosis contribute to a delayed start of antifungal therapy. In addition, the emergence of resistance to triazole antifungal agents puts emphasis on early surveillance for azole-resistant Aspergillus species. We present a patient with putative CAPA due to Aspergillus fumigatus with identification of a triazole-resistant isolate during therapy. We underline the challenges faced in the management of these cases, the importance of early diagnosis and need for surveillance given the emergence of triazole resistance.

Keywords: Aspergillus fumigatus; CAPA; ICU; SARS-CoV-2; TR34L98H; azole-resistant Aspergillus; co-infection; pulmonary aspergillosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Low-dose chest CT showing extensive centralized and peripheral bilateral ground glass opacities with left-sided consolidations and bilateral fibrotic bands. No pleural effusion. No vascular enlargement and no specific suggestions of aspergillosis.
Figure 2
Figure 2
Case timeline with microbiology.
See this image and copyright information in PMC

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