COVID-19相关肺曲霉病合并COVID-19相关肺毛霉病1例  

A case of COVID-19-associated pulmonary aspergillosis combined with COVID-19-associated pulmonary mucormycosis

作　　者：郑远江 侯江燕 钟娟 叶贤伟[3] Zheng Yuanjiang;Hou Jiangyan;Zhong Juan;Ye Xianwei(First Clinical Medical College of Zunyi Medical University,Zunyi 563000,China;Department of Respiratory Medicine,Nankang District Hospital of Traditional Chinese Medicine,Ganzhou 341499,China;Department of Respiratory and Critical Care Medicine,Guizhou Provincial People′s Hospital,Guiyang 550002,China)

机构地区：[1]遵义医科大学第一临床医学院,遵义563000 [2]赣州市南康区中医院呼吸内科,赣州341499 [3]贵州省人民医院呼吸与危重症医学科,贵阳550002

出　　处：《中华结核和呼吸杂志》2025年第3期267-271,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家自然科学基金(82460015);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2019PT320003)。

摘　　要：新型冠状病毒感染(COVID-19)相关的侵袭性霉菌是指COVID-19感染期间出现的侵袭性霉菌感染,包括COVID-19相关肺曲霉病、COVID-19相关肺毛霉病。本文报道了1例多次感染COVID-19,肺部CT检查提示肺部空洞及胸腔积液,通过肺泡灌洗液病理检查及宏基因组二代测序诊断的COVID-19相关肺曲霉病及COVID-19相关肺毛霉病混合感染患者。本文强调,糖尿病患者合并COVID-19感染出现不能用常见感染性疾病或肺部肿瘤解释的影像学表现时,应怀疑CAPA及CAPM可能,需及时完善相关检查,获取组织病理及病原学、分子生物学诊断依据。早期有效的抗真菌治疗可能有助于改善患者预后。COVID-19-associated invasive fungal infections are fungal infections that develop during COVID-19,including pulmonary aspergillosis(CAPA)and pulmonary mucormycosis(CAPM).This report presents a case of a patient with recurrent COVID-19 infections who showed pulmonary cavities and pleural effusion on chest CT.A mixed diagnosis of CAPA and CAPM was confirmed by histopathological analysis of bronchoalveolar lavage fluid and metagenomic next-generation sequencing.This study highlights the importance of suspecting CAPA and CAPM in diabetic COVID-19 patients with unexplained radiological findings that cannot be attributed to common infections or pulmonary tumors.Prompt and thorough diagnostic investigations,including histopathology,microbiology,and molecular techniques,are essential for accurate diagnosis.Early and effective antifungal treatment can significantly improve patient outcomes.

关 键 词：冠状病毒感染 分子生物学诊断 感染性疾病 混合感染 组织病理 肺部肿瘤 宏基因组 肺曲霉病 

分 类 号：S43[农业科学—农业昆虫与害虫防治]