Case Report: Chronic Cavitatory Pulmonary Aspergillosis after COVID-19

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  • 1 Department of Pulmonary Medicine, Manipal Hospital Whitefield, Bangalore, India;
  • | 2 Department of Critical Care Medicine, Manipal Hospital Whitefield, Bangalore, India

Chronic pulmonary aspergillosis can present in four distinct clinical syndromes, one of which is chronic cavitary pulmonary aspergillosis (CCPA). CCPA is generally associated with a mildly immunosuppressed state or, in immunocompetent patients, with structural lung damage. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with reactivation of previous quiescent infections such as tuberculosis and invasive fungal infections, but CCPA in a patient with COVID-19 is rarely reported. Here we present the case of a 57-year-old man with CCPA associated with COVID-19 infection in whom latent aspergilloma was most likely activated after SARS-CoV-2 infection. The patient presented with severe COVID and, after initial response to treatment, started to deteriorate due to reactivation of latent aspergilloma to a more aggressive CCPA form. After confirmation of the diagnosis, the patient was initiated on treatment with voriconazole. He showed a good response to treatment with clinicoradiological response. This case also depicts one of the common causes of clinical deterioration in otherwise recovering COVID-19 patients.

Author Notes

Address correspondence to Sheetal Chaurasia, Department of Pulmonary Medicine, Manipal Hospital Whitefield, Hoodi, Bangalore, India 560066. E-mail: sheetal.utkalit@gmail.com

Authors’ addresses: Sheetal Chaurasia and Saurav Chowdhury, Department of Pulmonary Medicine, Manipal Hospital Whitefield, Bangalore, India, E-mails: sheetal.utkalit@gmail.com and saurav.chowdhury@manipalhospitals.com. Manjunath Thimmappa, Department of Critical Care Medicine, Manipal Hospital Whitefield, Bangalore, India, E-mail: manjut1110@yahoo.co.in.

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