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Invasive pulmonary aspergillosis after treatment with tocilizumab in a patient with COVID-19 ARDS: a case report

Celeste Witting1, Jessica Quaggin-Smith2, Ruben Mylvaganam3

  • 1Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Diagnostic Microbiology and Infectious Disease
|January 3, 2021
PubMed

Insights

Tocilizumab treatment for critically ill COVID-19 patients can increase the risk of invasive pulmonary aspergillosis. This case highlights the need to monitor for opportunistic infections during immunomodulatory therapy.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Interleukin-6 (IL-6) receptor antagonists like tocilizumab are used in severe coronavirus disease-2019 (COVID-19).
  • Immunomodulatory therapies can alter host defense mechanisms.

Observation:

  • A previously immunocompetent male patient with COVID-19 received tocilizumab treatment.
  • The patient subsequently developed invasive pulmonary aspergillosis.

Findings:

  • Tocilizumab therapy was associated with the development of invasive pulmonary aspergillosis in an immunocompetent patient.
  • This suggests a potential link between IL-6 receptor antagonism and susceptibility to opportunistic fungal infections.

Implications:

  • Clinicians should consider the risk of opportunistic infections, such as invasive pulmonary aspergillosis, in patients receiving tocilizumab for COVID-19.
  • Vigilance for fungal infections is crucial during immunomodulatory treatment for critical illnesses.
Keywords:
COVID-19aspergillosisfungal infectionsopportunistic Infectionspulmonary diseasetocilizumab

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