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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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A Case Series Demonstrating the Difficulties in Diagnosing COVID-19 Associated Pulmonary Aspergillus

Sindhubarathi Murali1, Hanish Jain1, Saketh Velepati1

  • 1Internal Medicine, Upstate University Hospital, Syracuse, USA.

Cureus
|February 23, 2023
PubMed

Insights

Diagnosing invasive Aspergillosis in critically ill COVID-19 patients is challenging. Early detection of COVID-19-associated pulmonary Aspergillus (CAPA) is vital for improving patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pulmonology

Background:

  • COVID-19-associated acute respiratory distress syndrome (ARDS) frequently involves co-infections.
  • Invasive Aspergillosis is a known complication, but diagnosis in ICU patients remains difficult.
  • Distinguishing true infection from colonization is a significant diagnostic hurdle.

Observation:

  • Three intensive care unit (ICU) cases of COVID-19-associated pulmonary Aspergillus (CAPA) are presented.
  • These cases highlight the diagnostic challenges in critically ill patients.
  • The distinction between Aspergillus colonization and invasive infection was problematic.

Findings:

  • COVID-19-associated pulmonary Aspergillus (CAPA) presents diagnostic difficulties in the ICU setting.
  • Timely diagnosis is crucial due to high morbidity and mortality associated with CAPA.
  • The presented cases underscore the complexities in identifying and managing invasive fungal infections.

Implications:

  • Increased awareness of CAPA diagnostic challenges is needed to improve patient care.
  • Enhanced diagnostic strategies may be required for critically ill COVID-19 patients.
  • Improved management of CAPA can potentially reduce mortality in severe COVID-19 cases.
Keywords:
aspergillus bronchopneumoniacovid-19medical intensive care unitmissed diagnosisprolonged mechanical ventilation

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