Case series of invasive lung infections by Aspergillus species and zygomycosis among post COVID-19 and post-transplant individuals.

Abstract

Airborne pathogens like Aspergillus bring the lungs in the frontline for defense. Pulmonary diseases caused by Aspergillus species are broadly classified as aspergilloma, chronic necrotizing pulmonary aspergillosis, invasive pulmonary aspergillosis (IPA), and bronchopulmonary aspergillosis. Intensive care unit (ICU) admission is required for a large number of patients associated with IPA. It is not yet known whether patients with coronavirus disease 2019 (COVID-19) are at a similar risk for IPA as for influenza. However, usage of steroids plays a leading role in COVID-19. The family Mucoraceae includes filamentous fungi of the order Mucorales, causing a rare opportunistic fungal infection known as mucormycosis. The most commonly reported clinical presentations of mucormycosis are rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and others. Here, we report a case series of invasive pulmonary infection by various fungi like Aspergillus niger, Aspergillus fumigatus, Rhizopus oryzae, and Mucor species. Specific diagnosis was made based on microscopy, histology, culture, lactophenol cotton blue (LPCB) mount, and chest radiography and computed tomography (CT). To conclude, opportunistic fungal infections like those due to Aspergillus species and mucormycosis are most commonly associated with hematological malignancies, neutropenia, transplant patients, and diabetes. Therefore, early diagnosis by direct microscopy, surgical interventions, and effective antifungal treatment form the ideal management for invasive fungal infections like aspergillosis and mucormycosis, instead of waiting for the culture reports.