Acute Respiratory Distress Syndrome Due to COVID-19-Associated Pulmonary Aspergillosis with Rare Extensive Tracheobronchial Pseudomembranous Involvement: A Case Report.

IF 2.9 3区生物学 Q2 MYCOLOGY

Mycopathologia Pub Date : 2025-07-30 DOI:10.1007/s11046-025-00971-5

Liu He, Wei Wang, Danyan Cai, Xiaoshan Zhang, Xinyuan Tan

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Abstract

COVID-19-associated pulmonary aspergillosis (CAPA) significantly exacerbates the clinical outcomes of COVID-19 patients, contributing to heightened mortality. Aspergillus tracheobronchitis, a manifestation of invasive pulmonary aspergillosis, specifically involves the tracheobronchial tree. According to the 2020 European Confederation of Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) consensus criteria, airway biopsy via bronchoscopy is the definitive method for CAPA diagnosis, underscoring its critical role in the management of COVID-19 patients. This case report describes an elderly male patient with COVID-19 who presented with extensive pseudomembranous involvement of the tracheobronchial tree, identified through bronchoscopy. The pseudomembrane, spanning from the glottis to the bronchi and characterized by its yellow-white translucency, was removed. Subsequent pathological examination and next-generation sequencing confirmed an Aspergillus infection. Despite the initiation of antifungal therapy, the patient's condition deteriorated, leading to his death.

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新冠肺炎相关肺曲霉病合并罕见广泛气管支气管假膜累及急性呼吸窘迫综合征1例

COVID-19相关肺曲霉病（CAPA）显著恶化了COVID-19患者的临床结果，导致死亡率升高。曲霉菌性气管支气管炎是侵袭性肺曲霉菌病的一种表现，主要累及气管支气管树。根据2020年欧洲医学真菌学联合会/国际人类和动物真菌学学会（ECMM/ISHAM）共识标准，支气管镜下气道活检是CAPA诊断的权威方法，强调了其在COVID-19患者管理中的关键作用。本病例报告描述了一位老年男性COVID-19患者，他通过支气管镜检查发现气管支气管树有广泛的假膜性受累。从声门到支气管的假膜被切除，其特征是黄白色的半透明。随后的病理检查和下一代测序证实了曲霉感染。尽管开始了抗真菌治疗，但患者病情恶化，最终导致死亡。

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来源期刊

Mycopathologia 生物-真菌学

CiteScore

6.80

自引率

3.60%

发文量

审稿时长

3 months

期刊介绍： Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.