Pulmonary cryptococcal infection after COVID-19 recovery:A case report
and literature review
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a respiratory
infectious disease caused by a new coronavirus called severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first reported
in Wuhan, China at the end of 2019, and quickly developed into a global
pandemic. By reviewing the clinical data of 1 patient with cryptococcus
pneumoniae infection after recovered from COVID-19 and reviewing
relevant literature, the following possible clinical consequences of
COVID-19 were discussed and corresponding relevant management strategies
were proposed. Case presentation: A 64-year-old female patient diagnosed
with COVID-19 was cured and discharged. Follow-up laboratory tests
showed that CD4+ cell count reduced and abnormal CD4+/CD8+ cell ratio,
and a growing solid lesion was found on computed tomography (CT) scan
after two mouths after discharge. Ineffective broad-spectrum antibiotics
treatment and positive cryptococcal capsular polysaccharide antigen
tests results indicating the suspicious invasive pulmonary fungal
infection due to immunodeficiency. After anti-fungal treatment, the
right lung lesion were significantly absorbed. Conclusion: After
recovery from COVID-19, T cell count decline may occur, accompanied by
host immune dysfunction. Clinicians should pay more attention to
secondary infections caused by weakened immunity of COVID-19 patients
after recovery, whom might be vigilant against opportunistic pathogens
such as Cryptococcus. Key words: COVID-19, invasive fungal infection,
Cryptococcus, lymphopenia.