Abstract
Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.
Highlights
COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge
With the appearance of atypical cases of pneumonia at the end of 2019, the new coronavirus (SARSCoV-2) was identified, and the disease caused by it, COVID-19, spread rapidly worldwide, generating the COVID-19 pandemic, present in 2021 [1,2,3]
COVID-19 can lead to acute respiratory distress syndrome, and in the case of diffuse alveolar involvement with the appearance of inflammatory exudate, patients diagnosed with COVID-19 have a degree of immunosuppression by decreased CD4 + and CD8 + T lymphocytes [10]
Summary
With the appearance of atypical cases of pneumonia at the end of 2019, the new coronavirus (SARSCoV-2) was identified, and the disease caused by it, COVID-19, spread rapidly worldwide, generating the COVID-19 pandemic, present in 2021 [1,2,3]. Coinfection with Candida and Aspergillus ranks first [7,8], with an increasing frequency, having a severe evolutionary potential, even fatal in some cases [7,9]. Patients with a critical form of the disease, admitted to the intensive care unit, requiring mechanical ventilation and a prolonged period of hospitalization have a greater predisposition to develop fungal co-infections [11]. These aspects suggest that patients, especially those with severe forms of the disease, may develop fungal infections in the middle of the disease course or in the more advanced stage [12]
Sign-in/Register to view highlights & summary 
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call