Abstract
A 67-year-old obese man (BMI 38.0) with type 2 diabetes mellitus (DM), chronic atrial fibrillation, and chronic lymphocytic leukemia stage II, stable for 8 years after chemotherapy, and a history of smoking presented to the ED with progressive dyspnea and fever due to SARS-CoV-2 infection. He was admitted to a general ward and treated with dexamethasone (6 mg IV once daily) and oxygen. On day 3 of hospital admission, he became progressively hypoxemic and was admitted to the ICU for invasive mechanical ventilation. Dexamethasone treatment was continued, and a single dose of tocilizumab (800 mg) was administered. On day 9 of ICU admission, voriconazole treatment was initiated after tracheal white plaques at bronchoscopy, suggestive of invasive Aspergillus tracheobronchitis, were noticed. However, his medical situation dramatically deteriorated.
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
MeSH terms
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Acute Kidney Injury / virology*
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Aged
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Amphotericin B / therapeutic use
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Antibodies, Monoclonal, Humanized / therapeutic use
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Antifungal Agents / therapeutic use*
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Atrial Fibrillation / complications
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Bronchoscopy
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COVID-19 / complications*
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Dexamethasone / therapeutic use
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Diabetes Mellitus, Type 2 / complications
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Fatal Outcome
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Humans
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Leukemia, Lymphocytic, Chronic, B-Cell / complications
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Male
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Mucormycosis / diagnosis*
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Mucormycosis / drug therapy*
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Nitriles / therapeutic use
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Obesity / complications
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Oxygen Inhalation Therapy
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Pulmonary Aspergillosis / diagnosis*
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Pulmonary Aspergillosis / drug therapy*
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Pyridines / therapeutic use
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Respiration, Artificial
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SARS-CoV-2
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Smoking / adverse effects
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Tomography, X-Ray Computed
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Triazoles / therapeutic use
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Voriconazole / therapeutic use
Substances
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Antibodies, Monoclonal, Humanized
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Antifungal Agents
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Nitriles
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Pyridines
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Triazoles
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isavuconazole
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Dexamethasone
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Amphotericin B
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tocilizumab
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Voriconazole