An Acute Pulmonary Coccidioidomycosis Coinfection in a Patient Presenting With Multifocal Pneumonia With COVID-19

Chang, Cameron Casey; Senining, Randolph; Kim, Jessica; Goyal, Rakesh

doi:10.1177/2324709620972244

Cited by 29 publications

(35 citation statements)

References 5 publications

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“… 1 We posit that his initially subclinical infection was worsened by SARS-CoV-2-mediated immunosuppression. Although Coccidioides infection has been described during the management of COVID-19 before, 16 it is recognized that our patient may have had two unrelated primary infectious processes occurring simultaneously. This is improbable: coccidioidomycosis is not a contagious disease between humans, and Coccidioides is not endemic in Guam, with his only potential location for infection having been in California before deployment.…”

Section: Discussionmentioning

confidence: 78%

Accelerated Progression of Disseminated Coccidioidomycosis Following SARS-CoV-2 Infection: A Case Report

Krauth

Jamros

Rivard³

et al. 2021

Military Medicine

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We describe a patient with subclinical coccidioidomycosis who experienced rapid disease dissemination shortly after SARS-CoV-2 infection, suggesting host immune response dysregulation to coccidioidomycosis by SARS-CoV-2. We hypothesize that disrupted cell-mediated signaling may result after SARS-CoV-2 infection leading to functional exhaustion and CD8+ T-cell senescence with impairment in host cellular response to Coccidioides infection.

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Section: Discussionmentioning

confidence: 78%

Accelerated Progression of Disseminated Coccidioidomycosis Following SARS-CoV-2 Infection: A Case Report

Krauth

Jamros

Rivard³

et al. 2021

Military Medicine

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“…Because SARS-CoV-2 and treatments such as dexamethasone or tocilizumab can impair the immune system, some researchers anticipated the possibility of fungal superinfection among COVID-19 patients ( 3 – 6 ). As of August 2020, researchers have documented COVID-19–associated pulmonary aspergillosis (CAPA) ( 7 – 9 ), invasive candidiasis ( 10 ), coccidioidomycosis ( 11 ), fusariosis ( 12 ), histoplasmosis ( 13 ), mucormycosis ( 14 ), pneumocystosis ( 15 ), and saccharomycosis ( 16 ). Varying cumulative rates of CAPA have been described, including rates of 0.7%–7.7% among COVID-19 patients ( 17 , 18 ), 2.5%–39.1% among ICU patients with COVID-19 ( 19 , 20 ), and 3.2%–29.6% among COVID-19 patients on mechanical ventilation ( 7 , 17 ).…”

mentioning

confidence: 99%

COVID-19–Associated Pulmonary Aspergillosis, March–August 2020

Salmanton‐García¹,

Sprute²,

Stemler³

et al. 2021

Emerg. Infect. Dis.

212

219

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Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease–associated pulmonary aspergillosis (CAPA) worldwide during March–August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identified in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.

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“…Information on endemic fungal co-infections with SARS-CoV-2 is scarce. Only five cases have been published so far, two of COVID-19 and coccidioidomycosis in California, United States [ 102 , 103 ], and three of COVID-19 and histoplasmosis in Rio Grande, Southern Brazil, and Buenos Aires, Argentina [ 104 , 105 , 106 ] ( Table 5 ). Coccidioidomycosis co-infections were caused by C. immitis [ 102 , 103 ].…”

Section: Endemic Mycoses and Covid-19mentioning

confidence: 99%

“…Only five cases have been published so far, two of COVID-19 and coccidioidomycosis in California, United States [ 102 , 103 ], and three of COVID-19 and histoplasmosis in Rio Grande, Southern Brazil, and Buenos Aires, Argentina [ 104 , 105 , 106 ] ( Table 5 ). Coccidioidomycosis co-infections were caused by C. immitis [ 102 , 103 ]. They occurred in a man and a woman, both 48 years of age, with the main predisposing factor of residing in endemic areas [ 102 , 103 ].…”

Section: Endemic Mycoses and Covid-19mentioning

confidence: 99%

“…Coccidioidomycosis co-infections were caused by C. immitis [ 102 , 103 ]. They occurred in a man and a woman, both 48 years of age, with the main predisposing factor of residing in endemic areas [ 102 , 103 ]. The diagnosis was established with serological test results, and fluconazole was administered as an antifungal treatment.…”

Section: Endemic Mycoses and Covid-19mentioning

confidence: 99%

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Epidemiology of Systemic Mycoses in the COVID-19 Pandemic

Frías-De-León

Pinto‐Almazán

Hernández‐Castro

et al. 2021

JoF

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The physiopathologic characteristics of COVID-19 (high levels of inflammatory cytokines and T-cell reduction) promote fungal colonization and infection, which can go unnoticed because the symptoms in both diseases are very similar. The objective of this work was to study the current epidemiology of systemic mycosis in COVID-19 times. A literature search on the subject (January 2020–February 2021) was performed in PubMed, Embase, Cochrane Library, and LILACS without language restrictions. Demographic data, etiological agent, risk factors, diagnostic methods, antifungal treatment, and fatality rate were considered. Eighty nine publications were found on co-infection by COVID-19 and pneumocystosis, candidiasis, aspergillosis, mucormycosis, coccidioidomycosis, or histoplasmosis. In general, the co-infections occurred in males over the age of 40 with immunosuppression caused by various conditions. Several species were identified in candidiasis and aspergillosis co-infections. For diagnosis, diverse methods were used, from microbiological to molecular. Most patients received antifungals; however, the fatality rates were 11–100%. The latter may result because the clinical picture is usually attributed exclusively to SARS-CoV-2, preventing a clinical suspicion for mycosis. Diagnostic tests also have limitations beginning with sampling. Therefore, in the remainder of the pandemic, these diagnostic limitations must be overcome to achieve a better patient prognosis.

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An Acute Pulmonary Coccidioidomycosis Coinfection in a Patient Presenting With Multifocal Pneumonia With COVID-19

Cited by 29 publications

References 5 publications

Accelerated Progression of Disseminated Coccidioidomycosis Following SARS-CoV-2 Infection: A Case Report

Accelerated Progression of Disseminated Coccidioidomycosis Following SARS-CoV-2 Infection: A Case Report

COVID-19–Associated Pulmonary Aspergillosis, March–August 2020

Epidemiology of Systemic Mycoses in the COVID-19 Pandemic

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