key: cord-0836222-k6l4wgvu authors: Haglund, Anne; Christensen, Steffen; Kristensen, Lise; Gertsen, Jan Berg; Buus, Lone; Lausch, Karen Rokkedal title: Invasive pulmonary aspergillosis and hyperthermia in an immunocompetent patient with COVID-19 date: 2020-12-05 journal: Med Mycol Case Rep DOI: 10.1016/j.mmcr.2020.11.004 sha: 84e7f387f9bfcc7a15dd297f32cc6da7a5de5334 doc_id: 836222 cord_uid: k6l4wgvu Severely ill influenza patients are at increased risk of invasive pulmonary aspergillosis (IPA). Previous reports suggest that Coronavirus Disease 2019 (COVID-19) patients may also be at increased risk of IPA. Here we present an Aspergillus co-infection in a COVID-19 immunocompetent patient, complicated by bacteremia and persistent hyperthermia. We describe the challenges in diagnosing IPA in COVID-19 immunocompetent patients and how the patient responded to the treatment. The novel virus SARS-CoV-2 causes Coronavirus Disease 2019 (COVID-19), a disease ranging 16 from asymptomatic to critical illness, and can cause severe lung damage [1, 2] . About 5% of 17 COVID-19 patients require intensive care [3] [4] [5] . Severe COVID-19 has been suggested to be a 18 risk factor for the development of complicating aspergillus infection. Invasive pulmonary 19 aspergillosis (IPA) is a known complication of severe influenza pneumonia [6] [7] [8] . COVID-19 20 patients requiring ICU admission have a high mortality, and if they are co-infected with 21 Severely ill influenza patients are at increased risk of invasive pulmonary aspergillosis (IPA). Previous reports suggest that Coronavirus Disease 2019 (COVID-19) patients may also be at increased risk of IPA. Here we present an Aspergillus co-infection in a COVID-19 immunocompetent patient, complicated by bacteremia and persistent hyperthermia. We describe the challenges in diagnosing IPA in COVID-19 immunocompetent patients and how the patient responded to the treatment. Aspergillus, the mortality rate might be even higher, as it is also seen for influenza patients [ J o u r n a l P r e -p r o o f Bacterial and fungal coinfection 157 among hospitalised patients with COVID-19: A retrospective cohort study in a UK secondary 158 care setting Co-infections in people with COVID-19: a 160 systematic review and meta-analysis. The Journal of infection Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a 164 retrospective cohort study High rates of 167 influenza-associated invasive pulmonary aspergillosis may not be universal: a retrospective 168 cohort study from Alberta, Canada 170 Increased incidence of co-infection in critically ill patients with influenza Fatal Invasive 173 Aspergillosis and Coronavirus Disease in an Immunocompetent Patient A 176 clinical algorithm to diagnose invasive pulmonary aspergillosis in critically ill patients Diagnosing COVID-19-associated pulmonary aspergillosis. The Lancet Microbe Review 182 of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case 183 definition: an expert opinion Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-186 ECMM-ERS guideline EUCAST 189 DEFINITIVE DOCUMENT E.DEF 9.3.2: Method for the determination of broth dilution 190 minimum inhibitory concentrations of antifungal agents for conidia forming moulds Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the 193 Infectious Diseases Society of America Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the 197 European Organization for Research and Treatment of Cancer and the Mycoses Study Group 198 Education and Research Consortium Associated Pulmonary Aspergillosis CT Imaging Features of 202 2019 Novel Coronavirus (2019-nCoV)