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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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COVID-19 Associated Invasive Pulmonary Aspergillosis: Diagnostic and Therapeutic Challenges

Aia Mohamed1, Thomas R Rogers2, Alida Fe Talento1,3

  • 1Department of Microbiology, Our Lady of Lourdes Hospital Drogheda, A92 VW28 Co. Louth, Ireland.

Journal of Fungi (Basel, Switzerland)
|July 26, 2020
PubMed

Insights

Aspergillus co-infection, or invasive pulmonary aspergillosis, complicates severe COVID-19 pneumonia. Early diagnosis and antifungal susceptibility testing are crucial due to diagnostic challenges and emerging resistance.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Severe COVID-19 pneumonia can lead to acute respiratory distress syndrome.
  • Aspergillus co-infection, termed COVID-19-associated invasive pulmonary aspergillosis (CAPA), is an emerging complication.
  • Limited clinical awareness and diagnostic screening contribute to underdiagnosis.

Purpose of the Study:

  • To review reported cases of CAPA.
  • To highlight diagnostic and therapeutic challenges of this co-infection.
  • To emphasize the need for standardized case definitions and antifungal susceptibility testing.

Main Methods:

  • Systematic review of 38 published cases of CAPA.
  • Analysis of diagnostic criteria and treatment strategies.
  • Discussion of clinical implications and emerging antifungal resistance.

Main Results:

  • 38 cases of CAPA have been reported to date.
  • Significant diagnostic challenges exist due to overlapping symptoms with severe COVID-19.
  • Antifungal resistance, particularly to triazoles, is a growing concern.

Conclusions:

  • CAPA presents significant diagnostic and therapeutic hurdles.
  • Development of a clear case definition for CAPA is needed for early detection.
  • Antifungal susceptibility testing is essential for guiding appropriate therapy in CAPA patients.
  • Increased clinical vigilance is required to identify and manage this co-infection effectively.
Keywords:
COVID-19 associated invasive pulmonary aspergillosisCOVID-19 pneumoniadiagnosisinvasive pulmonary aspergillosismulti-triazole resistance

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