| Autor: |
Briones-Claudett KH; Universidad de Las Americas, Quito, Ecuador.; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Briones-Claudett MH; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Cordova Loor FJ; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Murillo Vasconez RA; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Rivera Salas CDR; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Bajaña Huilcapi CK; Ecuadorian Institute of Social Security, Babahoyo, Ecuador., Estupinan Vargas DF; Physiology and Respiratory-Center Briones-Claudett, Guayaquil, Ecuador., Rodriguez Garcia SE; Physiology and Respiratory-Center Briones-Claudett, Guayaquil, Ecuador., Benitez Sólis J; OMNI Hospital, Guayaquil, Ecuador., Briones Zamora KH; Universidad Espíritu Santo, Samborondón, Ecuador., Briones Marquez DC; Universidad de Guayaquil, Ecuador., Grunauer M; Universidad San Francisco de Quito, Ecuador. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of investigative medicine high impact case reports [J Investig Med High Impact Case Rep] 2022 Jan-Dec; Vol. 10, pp. 23247096221140250. |
| DOI: |
10.1177/23247096221140250 |
| Abstrakt: |
Unvaccinated patients with comorbidities that impair the immune function, such as type 2 diabetes mellitus, are more likely to develop severe COVID-19. The COVID-19-associated acute respiratory distress syndrome has raised new concerns in intensive care units globally owing to the presence of secondary fungal infections. We report the case of a 71-year-old man from Ecuador with a history of type 2 diabetes mellitus, severe COVID-19 pneumonia, and lung cavitation associated with triple infections with Trichosporon asahii , Klebsiella pneumoniae , and Pseudomonas aeruginosa . The patient with a history of high blood pressure and type 2 diabetes was admitted to our hospital from a private care center with a diagnosis of COVID-19-associated acute respiratory distress syndrome. On arrival, the patient presented with signs of hypoxemic respiratory failure. During his stay at another hospital, he had received tocilizumab and corticosteroid therapy. Therefore, intubation was performed and mechanical ventilation was initiated. The patient developed a septic shock and renal failure with a glomerular filtration rate of 27.5 mL/min/1.73 m 2 ; therefore, two hemodiafiltration sessions were started. The bronchoalveolar lavage revealed erythematous lesions in the bronchial tree and abundant purulent secretions and erosions in the bronchial mucosa, with a cavitary lesion in the right bronchial tree. The bronchoalveolar lavage samples were used to isolate Trichosporon asahii , Klebsiella pneumoniae , and Pseudomonas aeruginosa carbapenemase class A . Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) Biotyper mass spectrometry and polymerase chain reaction (PCR) molecular identification were performed. This case report suggested that patients with severe COVID-19 pneumonia, with or without comorbidities, are more susceptible to opportunistic infections. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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