Invasive pulmonary mucormycosis and aspergillosis are rare, life-threatening fungal infections. Most documented cases have been reported in patients with diabetes mellitus, neutropenia, or treatment with corticosteroids. Both infections have been recognized as secondary complications of COVID-19, especially among critically ill patients. We report the first case of combined probable pulmonary aspergillosis and possible mucormycosis in a male with COVID-19 in the ICU.

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PURPOSE: Rates of pleural effusion detection in the hospital setting have increased over the past decade with the use of more imaging modalities such as CT scans. Effusions are classified as exudative or transudative based on Modified Light's criteria by analyzing the fluid obtained through thoracentesis which helps establish the need for further invasive measures such as tube thoracostomy placement. While Modified Light's criteria have high specificity and sensitivity to determine effusion type, it requires an invasive procedure. Studies have shown mixed results regarding the utility of CT attenuation in addition to Modified Light's criteria in identifying effusion type. The goal of our study is to identify if CT attenuation (Hounsfield unit) can help classify tranusdative effusions without the need for a thoracentesis to decrease the number of invasive procedures.