COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy
<i>Background</i>: Establishing the diagnosis of COVID-19 and <i>Pneumocystis</i><i>jirovecii</i> pulmonary coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underes...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/4/302 |
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| author | Ionuț Isaia Jeican Patricia Inișca Dan Gheban Flaviu Tăbăran Maria Aluaș Veronica Trombitas Victor Cristea Carmen Crivii Lia Monica Junie Silviu Albu |
| author_facet | Ionuț Isaia Jeican Patricia Inișca Dan Gheban Flaviu Tăbăran Maria Aluaș Veronica Trombitas Victor Cristea Carmen Crivii Lia Monica Junie Silviu Albu |
| author_sort | Ionuț Isaia Jeican |
| collection | DOAJ |
| description | <i>Background</i>: Establishing the diagnosis of COVID-19 and <i>Pneumocystis</i><i>jirovecii</i> pulmonary coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underestimated in COVID-19 patients. <i>Case presentation</i>: We report the case of a 52-year-old male patient, who presented to the emergency department for severe dyspnea and died 17 h later. The RT-PCR test performed at his admission was negative for SARS-CoV-2. Retesting of lung fragments collected during autopsy revealed a positive result for SARS-CoV-2. Histopathological examination showed preexisting lesions, due to comorbidities, as well as recent lesions: massive lung thromboses, alveolar exudate rich in foam cells, suprapleural and intra-alveolar <i>Pneumocystis</i><i>jirovecii</i> cystic forms, and bilateral adrenal hemorrhage. <i>Conclusion</i>: COVID-19 and <i>P.</i><i>jirovecii</i> coinfection should be considered, particularly in critically ill patients, and we recommend the systematic search for <i>P. jirovecii</i> in respiratory samples. |
| first_indexed | 2024-03-10T12:56:50Z |
| format | Article |
| id | doaj.art-231046b3fbca4259865d42654f73f3e0 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T12:56:50Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-231046b3fbca4259865d42654f73f3e02023-11-21T11:48:20ZengMDPI AGMedicina1010-660X1648-91442021-03-0157430210.3390/medicina57040302COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through AutopsyIonuț Isaia Jeican0Patricia Inișca1Dan Gheban2Flaviu Tăbăran3Maria Aluaș4Veronica Trombitas5Victor Cristea6Carmen Crivii7Lia Monica Junie8Silviu Albu9Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, RomaniaDepartment of Pathology, County Emergency Hospital Deva, 330084 Deva, RomaniaDepartment of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, RomaniaDepartment of Pathology, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, RomaniaDepartment of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania Department of Head and Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, RomaniaDepartment of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, 400162 Cluj-Napoca, RomaniaDepartment of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, RomaniaDepartment of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania Department of Head and Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania<i>Background</i>: Establishing the diagnosis of COVID-19 and <i>Pneumocystis</i><i>jirovecii</i> pulmonary coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underestimated in COVID-19 patients. <i>Case presentation</i>: We report the case of a 52-year-old male patient, who presented to the emergency department for severe dyspnea and died 17 h later. The RT-PCR test performed at his admission was negative for SARS-CoV-2. Retesting of lung fragments collected during autopsy revealed a positive result for SARS-CoV-2. Histopathological examination showed preexisting lesions, due to comorbidities, as well as recent lesions: massive lung thromboses, alveolar exudate rich in foam cells, suprapleural and intra-alveolar <i>Pneumocystis</i><i>jirovecii</i> cystic forms, and bilateral adrenal hemorrhage. <i>Conclusion</i>: COVID-19 and <i>P.</i><i>jirovecii</i> coinfection should be considered, particularly in critically ill patients, and we recommend the systematic search for <i>P. jirovecii</i> in respiratory samples.https://www.mdpi.com/1648-9144/57/4/302COVID-19SARS-CoV-2<i>Pneumocystis jirovecii</i>pneumoniacoinfectionautopsy |
| spellingShingle | Ionuț Isaia Jeican Patricia Inișca Dan Gheban Flaviu Tăbăran Maria Aluaș Veronica Trombitas Victor Cristea Carmen Crivii Lia Monica Junie Silviu Albu COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy Medicina COVID-19 SARS-CoV-2 <i>Pneumocystis jirovecii</i> pneumonia coinfection autopsy |
| title | COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy |
| title_full | COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy |
| title_fullStr | COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy |
| title_full_unstemmed | COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy |
| title_short | COVID-19 and <i>Pneumocystis jirovecii</i> Pulmonary Coinfection—The First Case Confirmed through Autopsy |
| title_sort | covid 19 and i pneumocystis jirovecii i pulmonary coinfection the first case confirmed through autopsy |
| topic | COVID-19 SARS-CoV-2 <i>Pneumocystis jirovecii</i> pneumonia coinfection autopsy |
| url | https://www.mdpi.com/1648-9144/57/4/302 |
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