Acute Respiratory Distress Syndrome Due to COVID-19-Associated Pulmonary Aspergillosis with Rare Extensive Tracheobronchial Pseudomembranous Involvement: A Case Report.

Publication date: Jul 30, 2025

COVID-19-associated pulmonary aspergillosis (CAPA) significantly exacerbates the clinical outcomes of COVID-19 patients, contributing to heightened mortality. Aspergillus tracheobronchitis, a manifestation of invasive pulmonary aspergillosis, specifically involves the tracheobronchial tree. According to the 2020 European Confederation of Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) consensus criteria, airway biopsy via bronchoscopy is the definitive method for CAPA diagnosis, underscoring its critical role in the management of COVID-19 patients. This case report describes an elderly male patient with COVID-19 who presented with extensive pseudomembranous involvement of the tracheobronchial tree, identified through bronchoscopy. The pseudomembrane, spanning from the glottis to the bronchi and characterized by its yellow-white translucency, was removed. Subsequent pathological examination and next-generation sequencing confirmed an Aspergillus infection. Despite the initiation of antifungal therapy, the patient’s condition deteriorated, leading to his death.

Concepts Keywords
Aspergillosis Aged
Elderly Antifungal Agents
European Antifungal Agents
Pulmonary Aspergillus tracheobronchitis
Therapy Bronchoscopy
Case report
COVID-19
Extensive tracheobronchial pseudomembrane
Fatal Outcome
Fungal infection
Humans
Invasive Pulmonary Aspergillosis
Male
Pseudomembranous Aspergillus tracheobronchitis
Pulmonary Aspergillosis
Respiratory Distress Syndrome
SARS-CoV-2

Semantics

Type Source Name
disease MESH Acute Respiratory Distress Syndrome
disease MESH COVID-19
disease MESH Pulmonary Aspergillosis
disease MESH invasive pulmonary aspergillosis
disease IDO role
disease MESH Aspergillus infection
disease MESH death
disease MESH Fatal Outcome
disease MESH Fungal infection

Original Article

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