Long-term survival following medical management of Aspergillus endocarditis with dissemination as a consequence of steroid therapy in severe COVID-19 pneumonia

Kiran G Kulirankal; Ann Mary; Merlin Moni; Gopal S Pillai; Dipu T Sathyapalan

doi:10.1016/j.mmcr.2024.100638

Long-term survival following medical management of Aspergillus endocarditis with dissemination as a consequence of steroid therapy in severe COVID-19 pneumonia

Med Mycol Case Rep. 2024 Mar 1:43:100638. doi: 10.1016/j.mmcr.2024.100638. eCollection 2024 Mar.

Authors

Kiran G Kulirankal¹, Ann Mary², Merlin Moni¹, Gopal S Pillai³, Dipu T Sathyapalan¹

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, Amrita Institute of Medical Sciences, Kochi, India.
² Department of Internal Medicine, Amrita Institute of Medical Sciences, Kochi, India.
³ Department of Ophthalmology, Amrita Institute of Medical Sciences, Kochi, India.

Abstract

A male in his 40's with no known comorbidities developed severe COVID-19 pneumonia and received a four-week course of methylprednisolone. The patient subsequently developed disseminated Aspergillus endocarditis, manifesting as multiple organ involvement including the heart, eyes, and brain. Despite the poor prognosis generally associated with fungal endocarditis, the patient survived following aggressive medical management with a combination of liposomal amphotericin b and voriconazole therapy and is now doing well for over two years and is off antifungal therapy for a year.

Keywords: Aspergillus fumigatus; COVID-19; Covid pneumonia; Disseminated Aspergillus; Fungal endocarditis; Infectious diseases.

Publication types

Case Reports