39. Prolonged fever after COVID-19 associated pulmonary Aspergillus (CAPA): A case report

Do Thi Dai Trang, Nguyen Hoai Thuong

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Abstract

COVID-19 associated pulmonary Aspergillosis (CAPA) is a new disease characterized by secondary Aspergillus mold infection in patients with COVID-19. It primarily affects COVID-19 patients in critical state requiring care in intensive care units and has a high mortality rate. We report a case of an 11-year-old girl with a healthy history and mild COVID-19 infection, who was admitted to the hospital with a fever lasting 1.5 months since the onset of COVID-19. The child was excluded from other causes of persistent fever and diagnosed with suspected case of CAPA. The child responded well to treatment with voriconazole. Conclusion: CAPA has non-specific clinical symptoms. In children with persistent fever after COVID-19 infection, the possibility of invasive fungal infection should be evaluated, including in children with mild COVID-19 who have a completely normal immune system and no risk factors.

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References

1. Hashim Z, Neyaz Z, Marak RSK, et al. Practice guidelines for the diagnosis of COVID-19-Associated pulmonary aspergillosis in an intensive care setting. J Intensive Care Med. 2022;37(8):985-997. doi: 10.1177/08850666211047166.
2. Bộ Y tế. Quyết định số 3429/QĐ-BYT ngày 14/7/2021 về việc ban hành “Hướng dẫn chẩn đoán và điều trị nhiễm nấm xâm lấn”. 2021
3. Koehler P, Bassetti M, Chakrabarti A, et al. Defining and managing COVID-19-associated pulmonary aspergillosis: The 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis. 2021;21(6):e149-e162. doi: 10.1016/S1473-3099(20)30847-1.
4. Lai CC, Yu WL. COVID-19 associated with pulmonary aspergillosis: A literature review. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi. 2021;54(1):46-53. doi: 10.1016/j.jmii.2020.09.004.
5. Salmanton-García J, Sprute R, Stemler J, et al. COVID-19 - Associated pulmonary aspergillosis, March - August 2020. Emerg Infect Dis. 2021;27(4):1077-1086. doi: 10.3201/eid2704.204895.
6. Bartoletti M, Pascale R, Cricca M, et al. Epidemiology of invasive pulmonary aspergillosis among intubated patients with COVID-19: A Prospective Study. Clin Infect Dis Off Publ Infect Dis Soc Am. 2021;73(11):e3606-e3614. doi:10.1093/cid/ciaa1065
7. Dellière S, Dudoignon E, Fodil S, et al. Risk factors associated with COVID-19-associated pulmonary aspergillosis in ICU patients: a French multicentric retrospective cohort. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2020:S1198-743X(20)30756-4. doi: 10.1016/j.cmi.2020.12.005.
8. Koehler P, Cornely OA, Böttiger BW, et al. COVID-19 associated pulmonary aspergillosis. Mycoses. 2020;63(6):528-534. doi: 10.1111/myc.13096.
9. Machado M, Valerio M, Álvarez-Uría A, et al. Invasive pulmonary aspergillosis in the COVID-19 era: An expected new entity. Mycoses. 2021;64(2):132-143. doi: 10.1111/myc.13213.
10. Nasir N, Farooqi J, Mahmood SF, et al. COVID-19-associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: An observational study from Pakistan. Mycoses. 2020;63(8):766-770. doi: 10.1111/myc.13135.
11. Roman-Montes CM, Martinez-Gamboa A, Diaz-Lomelí P, et al. Accuracy of galactomannan testing on tracheal aspirates in COVID-19-associated pulmonary aspergillosis. Mycoses. 2021;64(4):364-371. doi: 10.1111/myc.13216.
12. Hoenigl M, Seidel D, Sprute R, et al. COVID-19-associated fungal infections. Nat Microbiol. 2022;7(8):1127-1140. doi: 10.1038/s41564-022-01172-2.
13. Grasselli G, Cattaneo E, Florio G. Secondary infections in critically ill patients with COVID-19. Crit Care. 2021;25(1):317. doi: 10.1186/s13054-021-03672-9.
14. Dimopoulos G, Almyroudi MP, Myrianthefs P, et al. COVID-19-Associated pulmonary aspergillosis (CAPA). J Intensive Med. 2021;1(2):71-80. doi: 10.1016/j.jointm.2021.07.001.
15. Tong X, Liu T, Jiang K, et al. Clinical characteristics and prognostic risk factors of patients with proven invasive pulmonary aspergillosis: A single-institution retrospective study. Front Med. 2021;8:756237. doi: 10.3389/fmed.2021.756237.