Chronic Pulmonary Aspergillosis During Convalescence From Severe COVID-19 Treated With Oral Itraconazole: A Report of Two Cases.

Autor:	Horiuchi H; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Utada S; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Shinomiya Y; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Miyagawa T; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Sogo A; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Niida S; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Okano H; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Suzuki N; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Otsuka T; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Miyazaki H; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN., Furuya R; Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center, Yokohama, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Jul 26; Vol. 14 (7), pp. e27281. Date of Electronic Publication: 2022 Jul 26 (Print Publication: 2022).
DOI:	10.7759/cureus.27281
Abstrakt:	Invasive pulmonary aspergillosis (IPA) has been reported to occur secondary to coronavirus disease 2019 (COVID-19), and the condition has been termed COVID-19-associated pulmonary aspergillosis (CAPA). We diagnosed two severe COVID-19 cases with multiple cavitary lung lesions and chronic pulmonary aspergillosis (CPA) on days 58 and 48 of admission, respectively, with gradual improvement in the respiratory status. Both patients were positive for Aspergillus- precipitating antibodies (APAb). We chose oral itraconazole (ITCZ) for both patients because of its convenience in terms of long-term treatment. Cavitary lesions diminished after ITCZ administration. The risk factors for pulmonary aspergillosis in both patients were determined to be steroid pulse therapy, use of baricitinib, diabetes mellitus (DM), ICU admission, long hospital stay, and the use of broad-spectrum antibiotics. Pulmonary aspergillosis must be suspected in patients with severe COVID-19, even if they are asymptomatic, because not only IPA but also CPA can occur following COVID-19. Therefore, oral ITCZ may be a treatment option for CPA following COVID-19. Competing Interests: All authors meet the ICMJE authorship criteria; Hiroshi Horiuchi was responsible for the conception of the work, interpretation of data, and drafting of the work. Shusuke Utada, Yoshie Shinomiya, Azusa Sogo, Takao Miyagawa, Shoko Niida, Hiromu Okano, Naoya Suzuki, Tsuyoshi Otsuka, Hiroshi Miyazaki, and Ryosuke Furuya were responsible for the design of the work and the analysis of data. All authors revised this work critically and contributed to the writing of the final manuscript. All authors agreed to be accountable for all aspects of the work. (Copyright © 2022, Horiuchi et al.)
Databáze:	MEDLINE
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