COVID-19 and Pulmonary Tuberculosis Increase Risk of Undiagnosed Chronic Pulmonary Aspergillosis

Strategic Insights -

A new study has reported a case of Achromobacter spp. infection in an immunocompetent woman with a history of pulmonary tuberculosis (PTB) and COVID-19. The study suggests that the high burden of TB and COVID-19 in Cameroon may lead to underreported pulmonary bacterial and fungal superinfections.

Key Takeaways:

  • A 63-year-old Cameroonian woman presented with cough, productive muco-purulent sputum, asthenia, headaches, and chest pain for 8 weeks, with a history of PTB in 2002 and COVID-19 in 2020.
  • Chest X-ray showed bronchiectasis in the right lung and features of healed PTB, while SARS-CoV-2 antigen, antibody, and real-time polymerase chain reaction tests were negative.
  • Sputum samples grew Aspergillus flavus complex and Aspergillus niger complex, and serum Aspergillus-specific IgG-IgM antibody was positive, suggestive of chronic pulmonary aspergillosis (CPA).
  • The patient showed significant clinical improvement on itraconazole treatment, but relapsed 1 month later with severe symptoms and elevated white blood cells.
  • A chest CT scan showed a middle right mediastinal tissue mass, and bronchoalveolar lavage (BAL) and lung biopsy testing yielded a negative result for PTB, invasive aspergillosis, and lung cancer.
  • The BAL sample grew Achromobacter spp., and the patient was initiated on imipenem with resolution of symptoms.

Statistics:

  • The study reports a case of Achromobacter spp. infection in an immunocompetent woman with a history of PTB and COVID-19.
  • The patient presents with a 8-week history of symptoms, with a chest X-ray showing bronchiectasis in the right lung and features of healed PTB.
  • The patient shows a significant clinical improvement on itraconazole treatment, but relapses with severe symptoms and elevated white blood cells.

Sources:

  • Department of Microbiology and Parasitology
  • Clinical Case Reports (http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2050-0904)
  • Wongouanom Kuate, Department of Microbiology and Parasitology, Faculty of Science University of Buea Buea Cameroon
  • Felix Bongomin, David W. Denning
  • Alcaligenaceae, Betaproteobacteria, Drugs and Therapies, Health and Medicine, Risk and Prevention, Gram-Negative Bacteria, Bacterial Infections and Mycoses, Gram-Negative Aerobic Rods and Cocci.