Penicillium digitatum , First Clinical Report in Chile: Fungal Co-Infection in COVID-19 Patient.
Isabel Iturrieta-GonzálezAnnesi GiacamanPatricio Godoy-MartínezFernando VegaMarcela SepúlvedaCledir SantosValentina ToledoGonzalo RiveraLeandro OrtegaAndrés San MartínVitalia BahamondesFelipe CollaoRaúl Segundo SánchezFlery Fonseca-SalamancaPublished in: Journal of fungi (Basel, Switzerland) (2022)
Penicillium digitatum is one of the most important phytopathogens. It causes deterioration and rotting of citrus fruits, generating significant economic losses worldwide. As a human pathogen, it is extremely rare. We present a case of pulmonary co-infection in a patient diagnosed with pneumonia due to SARS-CoV-2. A 20-year-old female patient, primigravid, 36 weeks of gestation, without comorbidities, and diagnosed with severe pneumonia due to the SARS-CoV-2, showed rapid lung deterioration for which their pregnancy was interrupted by surgery. The patient was hospitalized in the Intensive Care Unit (ICU), connected to mechanical ventilation and receiving corticosteroids and antibiotics. The diagnosis of pulmonary fungal infection was made through bronchoalveolar lavage (BAL) culture, and the species identification was performed by sequencing of β-tubulin. Phylogenetic analysis with related species was performed for the confirmation of species identification. Antifungal susceptibility tests were performed for itraconazole (4 µg/mL), voriconazole (2 µg/mL), and amphotericin B (2 µg/mL). The patient was successfully treated with itraconazole. This is the second worldwide report of pulmonary infection by P. digitatum and the first in Chile. Although it is a fungus that rarely infects humans, it could represent an emerging opportunistic fungal pathogen, with associated risk factors that should be considered in the differential diagnosis of Penicillium species isolated from infections in humans.
Keyphrases
- sars cov
- mechanical ventilation
- case report
- pulmonary hypertension
- intensive care unit
- candida albicans
- minimally invasive
- endothelial cells
- respiratory syndrome coronavirus
- acute coronary syndrome
- pregnant women
- respiratory failure
- early onset
- percutaneous coronary intervention
- genetic diversity
- preterm birth
- pregnancy outcomes