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PMC:7323532 JSONTXT 16 Projects

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Id Subject Object Predicate Lexical cue
T1 0-82 Sentence denotes Fatal Invasive Aspergillosis and Coronavirus Disease in an Immunocompetent Patient
T2 83-115 Sentence denotes Fatal Aspergillosis and COVID-19
T3 117-125 Sentence denotes Abstract
T4 126-295 Sentence denotes Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respiratory distress syndrome, especially those with severe influenza pneumonia.
T5 296-451 Sentence denotes We report a fatal case of invasive pulmonary aspergillosis in an immunocompetent patient in France who had severe coronavirus disease–associated pneumonia.
T6 453-661 Sentence denotes Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) experience major lung damage due to viral replication and the ensuing cytokine storm and complex inflammatory processes (1).
T7 662-805 Sentence denotes The severe damage to lung tissue can lead to secondary infections within a median of 17 days after onset of coronavirus disease (COVID-19) (2).
T8 806-1125 Sentence denotes Most immunocompetent patients who develop severe forms of COVID-19 have >1 underlying condition, such as chronic obstructive pulmonary disease, hypertension, diabetes, or chronic kidney disease (3), but none of these predisposing factors generally are associated with an increased risk for developing fungal infections.
T9 1126-1282 Sentence denotes Invasive aspergillosis is a well-described complication of severe influenza pneumonia (4,5), but many intensivists seem to overlook this superinfection (6).
T10 1283-1435 Sentence denotes A recent study reported a 19% incidence among 432 patients admitted to an intensive care unit (ICU) for influenza-related acute respiratory failure (4).
T11 1436-1581 Sentence denotes Moreover, in a small autopsy series of patients who died in 2003 from SARS, 10% (2/20) had an invasive infection suggestive of aspergillosis (7).
T12 1582-1778 Sentence denotes As the medical community confronts the ongoing COVID-19 pandemic, determining whether patients infected with SARS-CoV-2 develop fungal complications, especially invasive aspergillosis, is crucial.
T13 1779-1932 Sentence denotes We report the case of a 74-year-old immunocompetent man with severe COVID-19–associated pneumonia who rapidly developed invasive pulmonary aspergillosis.
T14 1933-2010 Sentence denotes The patient had several underlying chronic diseases but no pulmonary disease.
T15 2011-2327 Sentence denotes Among his existing conditions were asymptomatic and untreated myelodysplastic syndrome, diagnosed on the basis of hypereosinophilia, with CD8+ T-cell lymphocytosis, a normal karyotype and low-risk International Prognostic Scoring System score; Hashimoto’s thyroiditis; hypertension; and benign prostatic hypertrophy.
T16 2328-2455 Sentence denotes On the morning of March 23, day 1, the patient fell out of bed, was unable to get up on his own, and called emergency services.
T17 2456-2552 Sentence denotes The patient described a 1-week history of fever and cough followed by onset of dyspnea that day.
T18 2553-2642 Sentence denotes Clinical examination showed signs of acute respiratory failure, tachypnea, and hypoxemia.
T19 2643-2792 Sentence denotes The patient was intubated, transported to the hospital, and transferred to the ICU, where he required mechanical ventilation and vasopressor support.
T20 2793-2893 Sentence denotes The same day, we took a protected distal aspiration before intravenous administration of cefotaxime.
T21 2894-2990 Sentence denotes SARS-CoV-2 viral RNA was detected in this sample by using 2 distinct reverse transcription PCRs.
T22 2991-3124 Sentence denotes The sample revealed 104/mL of Haemophilus influenzae, which was not found in a second protected distal aspiration performed on day 2.
T23 3125-3217 Sentence denotes The patient’s condition worsened, and he had a PaO2/FIO2 ratio <140 mm Hg with FIO2 of 100%.
T24 3218-3304 Sentence denotes We performed a tracheal aspirate on day 4 and sent samples to the mycology laboratory.
T25 3305-3475 Sentence denotes PCR for Aspergillus fumigatus was positive (430 copies/mL; 2.6 log), but galactomannan in the aspirate assay was negative, and culture on Sabouraud agar remained sterile.
T26 3476-3669 Sentence denotes Results of testing of a second tracheal aspiration performed on day 9 yielded branched septate hyphae suggestive of Aspergillus sp. under microscopic examination after silver staining (Figure).
T27 3670-3813 Sentence denotes A. fumigatus PCR was once again positive with a higher number of copies (3,600 copies/mL; 3.55 log); the galactomannan assay was not available.
T28 3814-3870 Sentence denotes The patient died that day of severe respiratory failure.
T29 3871-3963 Sentence denotes Culture on Sabouraud agar later grew a mold identified as A. fumigatus by mass spectrometry.
T30 3964-4037 Sentence denotes Of note, SARS-CoV-2 RNA still was detectable in the tracheal aspirations.
T31 4038-4210 Sentence denotes Results of serum analyses, including galactomannan index determination, β-D-glucan assay, and A. fumigatus PCR, were negative in serum samples collected on day 4 and day 8.
T32 4211-4353 Sentence denotes Figure Microscopic image of silver-stained tracheal aspirate from an immunocompetent patient critically ill with coronavirus disease, France.
T33 4354-4418 Sentence denotes Filaments suggestive of Aspergillus sp. are shown (black arrow).
T34 4419-4449 Sentence denotes Original magnification ×1,000.
T35 4450-4657 Sentence denotes This case fulfills the criteria of putative invasive aspergillosis according to the classification defined by Blot et al. for the diagnosis of invasive pulmonary aspergillosis in critically ill patients (8).
T36 4658-4785 Sentence denotes Because the patient’s illness took a rapid and fatal course, we did not have time to initiate appropriate antifungal treatment.
T37 4786-4908 Sentence denotes As previously reported, respiratory samples led to a diagnosis of aspergillosis, but blood samples lacked sensitivity (4).
T38 4909-5151 Sentence denotes Moreover, Aspergillus PCR contributed to the diagnosis, but the galactomannan was negative, consistent with what we previously reported about the lower sensitivity of the galactomannan compared with PCR and culture in respiratory samples (9).
T39 5152-5357 Sentence denotes A patient with a fatal SARS-CoV-2 infection recently was reported to have A. flavus on tracheal aspirates culture, but other evidence was missing, and diagnosis of aspergillosis was not substantiated (10).
T40 5358-5555 Sentence denotes Additional assessments are urgently needed to thoroughly investigate cases and promptly establish and define the cumulative incidence of invasive aspergillosis in ICU patients with severe COVID-19.
T41 5556-5698 Sentence denotes In conclusion, we report a case of invasive pulmonary aspergillosis in an immunocompetent patient during severe COVID-19–associated pneumonia.
T42 5699-5879 Sentence denotes As the COVID-19 outbreak continues to spread worldwide, other reports are needed to assess the occurrence and frequency of fungal complications during severe SARS-CoV-2 infections.
T43 5881-5917 Sentence denotes Suggested citation for this article:
T44 5918-5990 Sentence denotes Blaize M, Mayaux J, Nabet C, Lampros A, Marcelin A-G, Thellier M, et al.
T45 5991-6074 Sentence denotes Fatal invasive aspergillosis and coronavirus disease in an immunocompetent patient.
T46 6075-6092 Sentence denotes Emerg Infect Dis.
T47 6093-6154 Sentence denotes 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.201603
T48 6155-6258 Sentence denotes Dr. Blaize is a microbiologist at Centre Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.
T49 6259-6329 Sentence denotes Her primary research interest is medical diagnosis of fungal diseases.