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Abstract

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Article in Japanese

Case Report

A pathological autopsy showing disseminated cryptococcosis after COVID-19 and ARDS treatment

Hideto Iizuka  Takahiro Fukui  Masatoshi Miyazaki  Hidehiro Irie  Yohei Funatsu  Hidefumi Koh 

Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital

ABSTRACT

This is the case of an 83-year-old male who suffered from COVID-19. He was refractory to various treatments at a previous hospital and developed acute respiratory distress syndrome (ARDS). Because of worsening oxygen levels despite two sessions of corticosteroid pulse therapy, he was transferred to our hospital on the 51st day of illness. Tocilizumab was administered in addition to corticosteroid pulse therapy; however, his clinical status deteriorated further, and he succumbed to the disease on the 58th day of illness. His family agreed to proceed with an autopsy. Progression of pulmonary fibrosis was noted on pathological autopsy, which was consistent with ARDS. In fact, Cryptococcus yeast bodies were found not only in his lungs, but also in other organs. He was diagnosed with disseminated cryptococcosis. Moreover, he also had a co-infection with cytomegalovirus. The patient suffered from opportunistic infections secondary to immunodeficiency associated with COVID-19 treatment.

KEYWORDS

Coronavirus disease 2019 (COVID-19)  Acute respiratory distress syndrome (ARDS)  Steroid pulse therapy  Tocilizumab  Disseminated cryptococcosis 

Received 11 Oct 2022 / Accepted 2 Jun 2023

AJRS, 12(5): 283-287, 2023

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