Fatal disseminated aspergillosis in an immunocompetent patient with COVID-19 due to Aspergillus ochraceus

Hakamifard, Atousa; Hashemi, Marzieh; Fakhim, Hamed; Aboutalebian, Shima; Hajiahmadi, Somayeh; Mohammadi, Rasoul

Aspergillus infection is a well-known complication of severe influenza and severe acute respiratory syndrome coronavirus (SARS-CoV), and these infections have been related with significant morbidity and mortality even when appropriately diagnosed and treated. Recent studies have indicated that SARS-CoV-2 might increase the risk of invasive pulmonary aspergillosis (IPA). Here, we report the first case of Aspergillus ochraceus in a SARS-CoV-2 positive immunocompetent patient, which is complicated by pulmonary and brain infections. Proven IPA is supported by the positive galactomannan test, culture-positive, and histopathological evidence. The patient did not respond to voriconazole, and liposomal amphotericin B was added to his antifungal regimen. Further studies are needed to evaluate the prevalence of IPA in immunocompetent patients infected with SARS-CoV-2. Consequently, testing for the incidence of Aspergillus species in lower respiratory secretions and galactomannan test of COVID-19 patients with appropriate therapy and targeted antifungal therapy based on the primary clinical suspicion of IPA are highly recommended.