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Cryptococcemia in a patient with COVID-19: A case report
Mohamad Y Khatib1, Amna A Ahmed1, Said B Shaat2
1Critical Care Medicine Department Hazm Mebaireek General Hospital (HMGH) Hamad Medical Corporation (HMC) Doha Qatar.
Clinical Case Reports
|February 18, 2021
Summary
Clinicians should carefully balance immunosuppressant drugs and tocilizumab in COVID-19 patients. This balance is crucial to prevent life-threatening infections such as Cryptococcemia, which can cause death within 30 days.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- COVID-19 treatment often involves immunosuppressive therapies.
- Tocilizumab, an interleukin-6 inhibitor, is used to manage hyperinflammation in severe COVID-19.
- The use of multiple immunosuppressants raises concerns about opportunistic infections.
Observation:
- A critical case of Cryptococcemia occurred in a COVID-19 patient treated with both immunosuppressants and tocilizumab.
- The patient developed a fatal disseminated fungal infection within 30 days.
Findings:
- Combined immunosuppression with tocilizumab may increase the risk of severe opportunistic infections.
- Cryptococcemia represents a significant, potentially fatal complication in immunocompromised COVID-19 patients.
Implications:
- Clinicians must carefully weigh the benefits and risks of combined immunosuppressive therapies for COVID-19.
- Vigilant monitoring for invasive fungal infections is essential in immunocompromised patients.
- Developing guidelines for the judicious use of immunosuppressants and immunomodulators in COVID-19 is critical.

