Work

Triple Pulmonary Coinfection with SARS-CoV-2, Nocardia cyriacigeorgica, and Aspergillus fumigatus Causing Necrotizing Pneumonia in an Immunomodulated Rheumatoid Arthritis Patient: Diagnostic and Therapeutic Insights

Year: 2025

Type: article

Abstract: Pulmonary coinfection involving both viral and opportunistic pathogens is an emerging challenge in immunosuppressed patients. We report the case of a 59-year-old man with rheumatoid arthritis on long-term immunosuppressive therapy who developed necrotizing pneumonia and acute respiratory failure and was ultimately diagnosed with triple pulmonary coinfection by SARS-CoV-2, Nocardia cyriacigeorgica, and Aspergillus fumigatus. Diagnosis required comprehensive imaging, bronchoscopy with BAL, and microbiological work-up. The case was complicated by septic shock, multiple organ failure, and family-driven end-of-life decisions. This report highlights the diagnostic and therapeutic complexity of triple coinfection in the ICU, emphasizing the importance of systematic microbiology, imaging, and interdisciplinary care in critically ill immunocompromised hosts.

Source: Life

DOI: 10.3390/life15091336

Authors: Wei-Hung Chang, Ting-Yu Hu, Li-Kuo Kuo

Institutions: Mackay Memorial Hospital, Mackay Medical University

Language: English

Topic: COVID-19 Clinical Research Studies

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137