Treatment of Post-COVID-19 Pulmonary Aspergilloma: Insights from a Clinical Case.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Atif S Siddiqui
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Abstract

BACKGROUND This report presents the case of a 49-year-old man with pulmonary aspergilloma 6 months after hospitalization and mechanical ventilation for COVID-19 who was treated with robot-assisted lobectomy. COVID-19-associated pulmonary aspergillosis is a life-threatening complication of SARS-CoV-2 infection. Aspergilloma, a delayed complication of COVID-19, is rare. Major risk factors for pulmonary aspergilloma include neutropenia, solid organ transplantation, prolonged high-dose corticosteroid therapy, hematological malignancy, cytotoxic therapy, acquired immunodeficiency syndrome, and chronic granulomatous disease. Common symptoms include cough, shortness of breath, fatigue, wheezing, weight loss, fever, and chest pain. Hemoptysis is the most severe complication of pulmonary aspergilloma. Treatment options include antifungals, bronchial artery embolization, and surgery. Surgical treatment is considered definitive for patients who do not respond to antifungal medications. CASE REPORT We describe the case of a 49-year-old man with pulmonary aspergilloma who developed a delayed sequela of SARS-CoV-2 infection. He presented to a pulmonary clinic 6 months after a severe COVID-19-related hospitalization, with symptoms of mild hemoptysis, cough, and shortness of breath. A computed tomography scan of the chest revealed a right upper lobe cavitary lesion approximately 9.6×6.1 cm in size. Bronchoalveolar lavage during bronchoscopy revealed Aspergillus fumigatus. The patient did not respond to antifungal treatment and was successfully treated with a robotic-assisted lobectomy. CONCLUSIONS Aspergillus infection should be considered in COVID-19 survivors with pulmonary symptoms. Minimally invasive robotic lobectomy is a feasible option for high-risk patients with post-COVID-19 aspergilloma and hemoptysis who are resistant to medical treatment.

后 COVID-19 肺曲霉瘤的治疗:一个临床病例的启示。
本报告报道了一名49岁男性因COVID-19住院并机械通气6个月后肺曲菌瘤患者接受机器人辅助肺叶切除术的病例。covid -19相关肺曲霉病是SARS-CoV-2感染的一种危及生命的并发症。曲霉菌瘤是COVID-19的一种延迟并发症,很罕见。肺曲菌瘤的主要危险因素包括中性粒细胞减少、实体器官移植、长时间高剂量皮质类固醇治疗、血液恶性肿瘤、细胞毒性治疗、获得性免疫缺陷综合征和慢性肉芽肿病。常见症状包括咳嗽、呼吸短促、疲劳、喘息、体重减轻、发烧和胸痛。咳血是肺曲菌肿最严重的并发症。治疗方案包括抗真菌药物、支气管动脉栓塞和手术。对于抗真菌药物无效的患者,外科治疗被认为是决定性的。病例报告我们描述了一例49岁男性肺曲菌瘤患者,他出现了SARS-CoV-2感染的延迟后遗症。他在因covid -19严重住院6个月后,出现轻度咯血、咳嗽和呼吸急促的症状,来到肺部诊所。胸部计算机断层扫描显示右上肺叶空洞病灶,大小约为9.6×6.1 cm。支气管镜检查支气管肺泡灌洗显示烟曲霉。患者对抗真菌治疗没有反应,通过机器人辅助肺叶切除术成功治疗。结论有肺部症状的COVID-19幸存者应考虑曲霉感染。微创机器人肺叶切除术是新型冠状病毒感染后曲菌肿和咯血高危患者治疗耐药的可行选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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