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Journal of Radiological Review 2021 September;8(3):249-53

DOI: 10.23736/S2723-9284.21.00157-4


language: English

As the pandemic continues: a Staphylococcus aureus methicillin-resistant and Candida albicans coinfection in a COVID-19 patient

Ivan NOSCHESE 1, Gianluigi DE ROSA 2, Michela CARFORA 2, Loredana DI NUZZO 2, Divina D’AURIA 1 *, Fabio PINTO 2

1 Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; 2 Department of Radiology, Maddaloni COVID Hospital, Maddaloni, Caserta, Italy

Over the last SARS-CoV-2 pandemic year, a large number of secondary bacterial or fungal pulmonary infections have been reported, mostly as complications of viral respiratory diseases. These resulted in an increased pneumonia severity in hospitalized patients with COVID-19 infection. Conversely, simultaneous occurrence of both infections has been described as a rare condition, and their prevalence is not well understood. Coinfection still represents an unexplored area associated with the COVID-19 pandemic, thanks to the continuous spread of the pathology worldwide (the high infectivity estimated by the World Health Organization [WHO] reached the R0 between 1.4 and 3.8): nevertheless, a remarkably higher incidence of intensive care admissions in patients with secondary coinfections has been observed. High doses and/or long-term use of corticosteroids are part of therapeutic management of the COVID-19 disease, but they may lead the development of risk infection, especially in patients admitted to intensive care or to infectious diseases departments, as well as noninvasive ventilation. In particular, since Staphylococcus aureus infection (mostly methicillin-resistant Staphylococcus aureus ventilator-acquired pneumonia) is often identified, a target antibiotic coverage is prescribed in order to reduce the risk of coinfection or even superinfection. Here, we describe the case of a 55-year-old woman, with a positive SARS-CoV-2 swab, admitted to our COVID-19 Hospital with typical symptoms of COVID-19 pneumonia, who experienced a worsening of clinical and radiological course caused by a double Staphylococcus aureus methicillin-resistant and Candida opportunistic infection.

KEY WORDS: Bacteria; COVID-19; Coinfection; SARS-CoV-2

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